Clinical recommendations for the care of people with treatment-refractory obsessive-compulsive disorder when undergoing deep brain stimulation

Acevedo Nicola; Castle David; Groves ClareBosanac PeterMosley Philip E.Rossell Susan

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Clinical recommendations for the care of people with treatment-refractory obsessive-compulsive disorder when undergoing deep brain stimulation

机译：Clinical recommendations for the care of people with treatment-refractory obsessive-compulsive disorder when undergoing deep brain stimulation

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Deep brain stimulation is an emerging therapy for treatment-refractory obsessive-compulsive disorder patients. Yet, accessibility is limited, treatment protocols are heterogeneous and there is no guideline or consensus on the best practices. Here, we combine evidence from scientific investigations, expert opinions and our clinical expertise to propose several clinical recommendations from the pre-operative, surgical and post-operative phases of deep brain stimulation care for treatment-refractory obsessive-compulsive disorder patients. A person-centered and biopsychosocial approach is adopted. Briefly, we discuss clinical characteristics associated with response, the use of improved educational materials, an evaluative consent process, comprehensive programming by an expert clinician, a more global assessment of treatment efficacy, multi-disciplinary adjunct psychotherapy and the importance of peer support programs. Furthermore, where gaps are identified, future research suggestions are made, including connectome surgical targeting, scientific evaluation of hardware models and health economic data. In addition, we encourage collaborative groups of data and knowledge sharing by way of a clinical registry and a peer group of programming clinicians. We aim to commence a discussion on the determinants of deep brain stimulation efficacy for treatment-refractory obsessive-compulsive disorder patients, a rare and severe patient group, and contribute to more standardized and evidence-based practices.

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《The Australian and New Zealand journal of psychiatry》 |2022年第10期|1219-1225|共7页
作者
Acevedo Nicola; Castle David; Groves ClareBosanac PeterMosley Philip E.Rossell Susan;
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作者单位

Swinburne University of Technology,Swinburne Univ Technol;

Dept Psychiat,Univ Melbourne;

Clin Serv,Clar Hlth CareClin Brain Networks Grp,QIMR Berghofer Med Res Inst;

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正文语种英语
中图分类神经病学与精神病学;
关键词
Deep brain stimulation; obsessive-compulsive disorder; psychiatry; clinical guidelines; recommendations; NUCLEUS-ACCUMBENS;

Clinical recommendations for the care of people with treatment-refractory obsessive-compulsive disorder when undergoing deep brain stimulation

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