Applicants for stereotactic neurosurgery for psychiatric disorders: role of the Flemish advisory board

Acta Psychiatr Scand. 2008 May;117(5):381-9. doi: 10.1111/j.1600-0447.2008.01166.x. Epub 2008 Mar 10.

Abstract

Objective: Research on stereotactic neurosurgery for psychiatric disorders (SNPD) is rapidly evolving. Knowledge on patients undergoing SNPD is of crucial importance. We describe applicants for SNPD and examine the necessity for a multidisciplinary advisory board.

Method: Summary of the current practice of the Flemish advisory board (SNPD committee) and analysis of a questionnaire investigating the attitude of clinicians on SNPD.

Results: In 7 years, 91 applications were submitted, nine patients did not fulfill diagnostic criteria for OCD, 65 patients received a positive recommendation, 50 SNPD procedures were performed. The prevalence of SNPD in the current year in Belgium is 0.6/million inhabitants. Ninety-seven per cent of clinicians consider the expertise and advice of the SNPD committee essential for indication setting. Forty-four percent of clinicians consider referral of a patient for capsulotomy, 82% for electrical brain stimulation.

Conclusion: Neurosurgery is exclusively considered for severe, treatment-refractory psychiatric disorders. Clinicians consider the SNPD committee essential in the decision-making process prior to intervention.

MeSH terms

  • Adolescent
  • Adult
  • Advisory Committees*
  • Aged
  • Antipsychotic Agents / therapeutic use*
  • Attitude of Health Personnel*
  • Belgium
  • Brain / physiopathology*
  • Brain / surgery*
  • Consensus*
  • Depressive Disorder, Major / physiopathology
  • Depressive Disorder, Major / surgery
  • Female
  • Humans
  • Informed Consent
  • Male
  • Mental Disorders / physiopathology*
  • Mental Disorders / surgery*
  • Middle Aged
  • Neurosurgical Procedures / instrumentation*
  • Obsessive-Compulsive Disorder / physiopathology
  • Obsessive-Compulsive Disorder / surgery
  • Patient Selection*
  • Professional Role*
  • Stereotaxic Techniques / instrumentation*
  • Surveys and Questionnaires

Substances

  • Antipsychotic Agents