World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders – Version 3. Part II: OCD and PTSD

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

“…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.…”

“…those of the Harvard South Shore Program (HSSP), National Institute of Mental Health and Neurosciences (NIMHANS), Anxiety Disorder Association of Canada (ADAC), British Association of Psychopharmacology (BAP) and WFSBP, had scores that fell between 50 and 58%. 15,18,19,21,22 These five guidelines with the lowest scores were not focused on DBS but on pharmacological or alternative options, and as such the reviewers did not consider that sufficient evidence was provided for the DBS recommendations made.…”

“…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.…”

“…The APA, NICE, BAP and WFSBP guidelines mentioned their general updating process on their website; however, three (APA, BAP and WFSBP) lacked details on specific timeframes scheduled for the update. 16,18,22 The types of included evidence also varied across guidelines (Table 2). The CNS guideline included evidence from clinical randomised controlled trials (RCTs; class 1) and a case-control study (class 2).…”

Selenium and Its Compounds in the Treatment of Anxiety and Related Disorders: A Scoping Review of Translational and Clinical Research

“…The pathophysiology of these disorders is complex, involving structural and functional alterations of specific cortical and subcortical brain structures [10][11][12], dysfunction of specific neurotransmitter systems [13,14], immune-inflammatory pathways [15], oxidative stress [16,17] and impaired neural plasticity [18]. In contemporary guidelines for the pharmacological management of anxiety and related disorders, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are the recommended first-line treatments [19,20]. Though these groups of drugs are superior to placebo, their effectiveness is often modest [21][22][23], and only about 40-60% of patients show a clinically significant response to them in short-to medium-term clinical trials [24][25][26].…”