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Deep brain stimulation for obsessive-compulsive disorders

Publication year 2014
Published in Journal of Neurology Neurosurgery and Psychiatry
Authors Pieter Ooms, Mariska H Mantione, M. Figee, P Richard Schuurman, Pepijn van den Munckhof, D. Denys

OBJECTIVE: To evaluate the long-term effects of deep brain stimulation (DBS) on quality of life (QOL) in therapy-refractory obsessive-compulsive disorder (OCD) patients.

DESIGN: 16 patients who met Diagnostic and Statistical Manual of Mental Disorders (4th ed) (DSM-IV) criteria for OCD and were considered therapy-refractory were treated with DBS. Patients were assessed 1 month before device implantation (T0), at 8 months of active stimulation (T1) and at 3-5 years of active stimulation (T2). QOL was measured with the WHO Quality of Life Scale-Brief Version (WHOQOL-BREF) that covers physical, psychological, social and environmental domains. The study was conducted between April 2005 and January 2011 at the Academic Medical Center, Amsterdam, The Netherlands.

RESULTS: At T1 and T2, we found significant improvement (p<0.05) in the general score and in the physical, psychological and environmental domains of WHOQOL-BREF. Between T1 and T2, the physical and psychological domains improved further (p<0.05). At T2, the general score improved by a total of 90%, the physical and psychological domains both improved by 39.5% and the environmental domain improved by 16%. The social domain did not change between baseline and follow-up assessments.

CONCLUSIONS: In line with symptom improvement, patient’s QOL improved in the general score and in three of the four WHOQOL-BREF domains. This suggests that the improvement caused by DBS is not limited to symptom reduction alone, but also has a positive influence on patients’ perception of their physical, psychological, environmental and global QOL.

CLINICAL TRIAL REGISTRATION: http://isrctn.org identifier: ISRCTN23255677.

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