Phenomenological Changes Associated with Deep Brain Stimulation for Obsessive Compulsive Disorder: A Cognitive...

Area of Science:

• Neuroscience
• Psychiatry
• Qualitative Research

Background:

• Current scientific understanding of deep brain stimulation (DBS) inadequately addresses its broad impact on patients' lives.
• Ethical and clinical considerations necessitate evaluating patient-reported outcomes in severe, complex conditions like obsessive compulsive disorder (OCD).
• The lived experience of individuals with OCD undergoing DBS requires comprehensive investigation.

Purpose of the Study:

• To conduct a lived experience investigation of individuals with obsessive compulsive disorder (OCD) undergoing deep brain stimulation (DBS).
• To provide a comprehensive evaluation of DBS-induced effects on OCD psychopathology from the patient perspective.
• To explore personally relevant outcomes and recovery models associated with DBS in OCD.

Main Methods:

• Employed semi-structured, open-ended interviews with six patients diagnosed with OCD and six of their carers.
• Utilized a blended analytical approach combining interpretative phenomenological analysis, inductive analysis, and thematic analysis.
• This represents the first qualitative investigation into DBS-induced changes in psychiatric patients and their carers.

Main Results:

• Participants reported profound psychopathological changes, including feeling more alive and experiencing improved cognitive-affective control.
• Individuals demonstrated greater engagement with the world and enhanced ability to manage their obsessive compulsive disorder (OCD).
• Suppression of OCD symptoms facilitated the re-emergence and development of self-constructs.

Conclusions:

• Deep brain stimulation (DBS) leads to significant positive phenomenological changes in individuals with obsessive compulsive disorder (OCD).
• Proposed a framework for phenomenological changes and a theoretical model for cognitive appraisal shifts influencing recovery.
• Findings offer critical implications for patient education, OCD recovery models, and the scientific understanding of DBS effects.