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Related Concept Videos

Obsessive-Compulsive Disorder01:28

Obsessive-Compulsive Disorder

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Obsessive-compulsive disorder (OCD) is a mental health condition characterized by recurrent obsessions, compulsions, or both, which consume significant time and interfere with daily functioning. Obsessions involve persistent, intrusive, and unwanted thoughts, images, or urges that evoke anxiety. Common examples include irrational fears of contamination or harm. Compulsions are repetitive behaviors or mental acts performed to reduce the anxiety caused by obsessions. For instance, individuals...
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Electroconvulsive Therapy01:30

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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Psychosurgery01:30

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Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
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[Consensus Statement on deep brain stimulation for treatment-resistant obsessive-compulsive disorder].

R J T Mocking, L Ackermans, I O Bergfeld

    Tijdschrift Voor Psychiatrie
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    Summary

    Deep brain stimulation (DBS) is effective for treatment-resistant obsessive-compulsive disorder (OCD), with a 66% response rate. A national protocol can improve access to this safe and cost-effective treatment for more patients.

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    Area of Science:

    • Neuroscience
    • Psychiatry
    • Neurosurgery

    Context:

    • Deep brain stimulation (DBS) is reimbursed in the Netherlands for treatment-resistant obsessive-compulsive disorder (OCD) since 2013.
    • Despite proven efficacy, DBS is underutilized in the Netherlands due to the absence of a national treatment protocol.

    Purpose:

    • To develop a nationwide, multidisciplinary treatment protocol for DBS in patients with treatment-resistant OCD.
    • To establish standardized recommendations for DBS application in OCD, covering indication, implantation, and parameter optimization.

    Summary:

    • DBS involves bilateral implantation of electrodes in the anterior limb of the internal capsule for severe, treatment-resistant OCD.
    • The treatment demonstrates a 66% average response rate, with significant placebo-controlled effects and long-term stability.
    • Reported side effects are generally transient, including hypomanic symptoms, fatigue, and cognitive complaints; perioperative complications are rare.

    Impact:

    • Adherence to the protocol can enhance the safety and efficacy of DBS for treatment-resistant OCD.
    • A national protocol is expected to increase referrals and timely access to DBS, benefiting more patients.
    • DBS is a cost-effective intervention that improves quality of life and functional recovery in patients with severe OCD.