Patient feedback and psychosocial outcomes of deep brain stimulation in people with obsessive-compulsive disorder

被引:2
作者
Acevedo, Nicola [1 ,2 ,6 ]
Castle, David J. [2 ,3 ]
Bosanac, Peter [2 ,4 ]
Groves, Clare [5 ]
Rossell, Susan L. [1 ,2 ]
机构
[1] Swinburne Univ Technol, Ctr Mental Hlth, John St, Melbourne, Vic, Australia
[2] St Vincents Hosp, 41 Victoria Parade, Melbourne, Vic, Australia
[3] Univ Toronto, Ctr Addict & Mental Hlth, 27 Kings Coll Cir, Toronto, ON, Canada
[4] Univ Melbourne, Dept Psychiat, Melbourne, Vic, Australia
[5] Clar Hlth, 55 Nicholson St, Melbourne, Vic, Australia
[6] Swinburne Univ, John St, Hawthorn, Vic, Australia
基金
英国医学研究理事会;
关键词
Neurostimulation; Deep brain stimulation; Obsessive -compulsive disorder; Psychosocial outcomes; Patient -centred care; SUBTHALAMIC NUCLEUS; PATIENTS EXPECTATIONS; PERSONALITY; INSTRUMENT;
D O I
10.1016/j.jocn.2023.04.012
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Severe and refractory psychiatric patients can experience complex and profound changes in symptomology, functioning and well-being from deep brain stimulation (DBS) therapy. Currently, the efficacy of DBS is assessed by clinician rated scales of primary symptoms, yet this does not capture the multitude of DBS mediated changes or represent the patient perspective. We aimed to elucidate the patient perspective in psychiatric DBS application by investigating 1) symptomatic, and 2) psychosocial changes, 3) therapeutic expectations and satisfaction, 4) decision-making capacity, and 5) clinical care recommendations from treatment refractory obsessive-compulsive disorder (OCD) DBS patients. Participants enrolled in an open label clinical trial of DBS therapy for OCD who had reached clinical response were invited to participate in a follow up survey. Participants completed a 1) feedback survey relating to goals, expectations, and satisfaction of therapy, and 2) self-report questionnaires on psychosocial functioning including quality of life, cognitive insight, locus of control, rumination, cognitive flexibility, impulsivity, affect, and well-being. Greatest change was reported for quality of life, rumination, affect and cognitive flexibility. Participants reported realistic expectations, high satisfaction, adequate pre-operative education and decision-making capacity; and advocated for greater access to DBS care and more widespread support services. This is the first identified investigation on psychiatric patient perspectives of functioning and therapeutic outcomes following DBS. Insights from the study have implications for informing psychoeducation, clinical practices, and neuroethical debates. We encourage a greater patient-centred and biopsychosocial approach in evaluating and managing OCD DBS patients, by considering personally meaningful goals and addressing symptomatic and psychosocial recovery.
引用
收藏
页码:80 / 85
页数:6
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