Deep brain stimulation - depression and obsessive-compulsive disorder

Abstract

The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

Clinical practice guidelines on the use of deep brain stimulation for the treatment of obsessive–compulsive disorder: systematic review

“…Table 1 presents the main characteristics of the included guidelines. Specifically, three were developed and published in the USA, 13,15,16 two in the UK, 17,18 one in Canada, 19 one in Brazil, 20 one in India 21 and one by the World Federation of Societies of Biological Psychiatry (WFSBP). 22…”

“…Specifically, three were developed and published in the USA, 13,15,16 two in the UK, 17,18 one in Canada, 19 one in Brazil, 20 one in India 21 and one by the World Federation of Societies of Biological Psychiatry (WFSBP). 22 Overall, all guidelines recommended the use of DBS after all other treatment options have failed to alleviate OCD symptoms, 13,15,16,[18][19][20][21][22] with the exception of the UK's National Institute for Health and Care Excellence (NICE) guideline; this was the only one to recommend DBS for use in research settings rather than clinical practice. 17 DBS settings were not specified in any of the included guidelines, with a recommendation on target regions made only by the Congress of Neurological Surgeons (CNS) guideline.…”

“…All guidelines included adult patients diagnosed with OCD according to DSM-5 as the target population. 13,[15][16][17][18][19][20][21][22] For the most part, cost considerations were not thoroughly considered as part of the analysis; the NICE guidelines stated that a health economic analysis was performed as part of the guideline development process but did not mention specific costs of DBS. 26 The NIMHANS only mentioned that DBS has high costs, especially during maintenance, but included no data or further details.…”