Online comments about psychiatric neurosurgery and psychopharmacological interventions: Public perceptions and concerns

Cabrera, Laura Y.; Brandt, Marisa; McKenzie, Rachel; Bluhm, Robyn

doi:10.1016/j.socscimed.2018.11.021

Cited by 16 publications

(9 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These concerns may originate, in part, from the widespread mis-use and abuse of psychiatric surgery in the 1950s 27,28 . Despite the significant advances in the field (e.g., the advent of stereotaxy, MRI-guided targeting, and more strict ethical oversight), lesional procedures are still viewed as risky or dangerous by a substantial proportion of psychiatrists 29 and the general public 30 . Although numerous recent RF and SRS trials have been effective at improving psychiatric symptoms, several of these studies reported persistent postoperative difficulties on cognitive tasks, particularly on tests of executive function [31][32][33][34][35] .…”

Section: Introductionmentioning

confidence: 99%

Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness

et al. 2020

View full text Add to dashboard Cite

Magnetic resonance-guided focused ultrasound (MRgFUS) anterior capsulotomy is a novel treatment option for patients with refractory obsessive compulsive disorder (OCD) or major depressive disorder (MDD). However, there is concern that lesional psychiatric surgery procedures may have adverse effects on cognition. In this study, we examined whether MRgFUS capsulotomy causes cognitive decline in patients with psychiatric illness. Ten patients with refractory OCD (n = 5) or MDD (n = 5) underwent MRgFUS capsulotomy. Cognitive functioning was measured at baseline as well as 6 months and 12 months postoperatively, with a battery of neuropsychological tests assessing domains of executive function, memory, and processing speed. Scores were analyzed at the individual-level, and changes ≥2 standard deviations were considered clinically significant. We also examined whether changes in clinical symptoms were associated with changes in cognitive performance. At baseline intellectual functioning was in the average to high-average range for the group. Following MRgFUS capsulotomy, there were no deteriorations in cognition that reached ≥2 standard deviations at 6 or 12 months. Eight out of ten patients demonstrated a ≥2 standard deviation improvement in at least one cognitive score at 6 or 12 months postoperatively. Improvements in clinical symptoms correlated significantly with self-reported improvements in frontal lobe function (p < 0.05), but not with objective measures of cognitive functioning. To summarize, MRgFUS capsulotomy did not result in cognitive decline in this cohort of patients with refractory OCD or MDD, suggesting that this procedure can be offered to patients with a very low risk of cognitive side effects.

show abstract

Section: Introductionmentioning

confidence: 99%

Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness

et al. 2020

View full text Add to dashboard Cite

show abstract

“…While people are familiar with psychotherapy (“talk therapy”) and medication as treatments for depression, fewer non-specialists have heard of electroceutical treatments, particularly newer therapies like rTMS and DBS. We previously found that members of the public often used their knowledge of older treatments, such as ECT and lobotomy, to make sense of newer surgical interventions in psychiatry, including DBS (Cabrera et al, 2019). These framing effects can be problematic considering that people’s old negative views can be extrapolated onto newer treatments.…”

Section: Discussionmentioning

confidence: 99%

“…Thomson et al (2019) found that clinicians who treated patients with DBS attributed personality changes to multiple factors, including both the stimulation itself and patients' expectations about the treatment. Members of the public also appear to judge the "reality" of depression based on the need for treatment, although they may tend to take depression more seriously when a more drastic intervention is involved (Cabrera et al, 2019). More work is needed to determine whether people's assessments of different therapies vary with the severity of depression they are intended to treat.…”

Section: How Are Electroceuticals Perceived As Affecting Personality and Sense Of Self?mentioning

confidence: 99%

“…Finally, two studies have examined public perceptions of the potential for personality change with DBS and other psychiatric interventions. One of these compared public perceptions of two broad kinds of psychiatric treatments, pharmaceutical and neurosurgical, and found that identity concerns are not a major theme in comments on online media articles (Cabrera et al, 2019). However, in a series of focus groups, Cabrera et al (2020) found that members of the public without a psychiatric diagnosis were concerned about the potential of psychiatric neurosurgery to threaten one’s authenticity, feeling that the surgery could cause cognitions or actions that were not those of the person’s “true self.”…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

They Affect the Person, but for Better or Worse? Perceptions of Electroceutical Interventions for Depression Among Psychiatrists, Patients, and the Public

et al. 2021

Self Cite

View full text Add to dashboard Cite

Responding to reports of cases of personality change following deep brain stimulation, neuroethicists have debated the nature and ethical implications of these changes. Recently, this literature has been challenged as being overblown and therefore potentially an impediment to patients accessing needed treatment. We interviewed 16 psychiatrists, 16 patients with depression, and 16 members of the public without depression, all from the Midwestern United States, about their views on how three electroceutical interventions (deep brain stimulation, electroconvulsive therapy, and transcranial magnetic stimulation) used to treat depression might affect the self. Participants were also asked to compare the electroceuticals’ effects on the self with the effects of commonly used depression treatments (psychotherapy and pharmaceuticals). Using qualitative content analysis, we found that participants’ views on electroceuticals’ potential effects on the self mainly focused on treatment effectiveness and side effects. Our results have implications for both theoretical discussions in neuroethics and clinical practice in psychiatry.

show abstract

“…How the legitimacy of a medical category and related clinical practice is contested and defended in the public sphere has drawn considerable attention from social scientists in recent decades. As the debate on its validity and appropriate intervention clearly demonstrates (Cabrera et al 2019), modern psychiatry provides a valuable vantage point for exploring the diverse sense‐making practices of and disputation amongst the social groups surrounding it. Attention‐deficit/hyperactivity disorder (ADHD) is a case in point.…”

Section: Introductionmentioning

confidence: 99%

More scientific, more ethical: The ADHD controversy and boundary‐work in Taiwan

Tseng

2021

Sociology Health & Illness

View full text Add to dashboard Cite

Attention‐deficit/hyperactivity disorder (ADHD) is one of the most controversial childhood psychiatric condition. With the globalisation of its diagnosis and treatment, Taiwan has followed other medically advanced countries in meeting the challenge of medicalising children's problematic behaviours and encountering the resistance discourses on ADHD. To contribute to the extant literature, this study employs the social worlds framework to decipher the relational dynamics amongst these competing discourses on ADHD, namely the mainstream psychiatry, the critiques of overdiagnosis and the antipsychiatric protest, and to suggest the links between these domestic advocacies and the relevant debates abroad. In addition, the concept of boundary‐work is used to analyse the strategies through which these collective actors pursue legitimacy for their respective claims. Based on the existing research of scientific and ethical boundary‐work, this study argues that when it comes to clinical practices fraught with uncertainties, these two seemingly distinct forms of boundary‐work may become mutually supportive in order to act as arbiters of disputes. Despite the disparity of power amongst these social worlds in this case study with seemingly predictable outcomes of the dispute, representing their heterogeneous narratives and the process of discursive struggle helps to destabilise the seemingly naturalised conceptualisation of biomedical ADHD.

show abstract

Online comments about psychiatric neurosurgery and psychopharmacological interventions: Public perceptions and concerns

Cited by 16 publications

References 41 publications

Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness

Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness

They Affect the Person, but for Better or Worse? Perceptions of Electroceutical Interventions for Depression Among Psychiatrists, Patients, and the Public

More scientific, more ethical: The ADHD controversy and boundary‐work in Taiwan

Contact Info

Product

Resources

About