Mendelsohn Daniel, Lipsman Nir, Lozano Andres M, Taira Takaomi, Bernstein Mark
Division of Neurosurgery, Vancouver General Hospital, University of British Columbia, Vancouver, B.C., Canada.
Stereotact Funct Neurosurg. 2013;91(5):306-13. doi: 10.1159/000348323. Epub 2013 Jun 22.
Interest in neurosurgery for psychiatric diseases (NPD) has grown globally. We previously reported the results of a survey of North American functional neurosurgeons that evaluated general attitudes towards NPD and the future directions of the field.
The purpose of this study was to expand on our previous work and obtain a snapshot in time of global attitudes towards NPD among practicing functional neurosurgeons. We measure general and regional trends in functional neurosurgery and focus specifically on surgery for mind and mood, while exploring the future prospects of the field.
We designed an online survey and distributed it electronically to 881 members of the following international organizations: World Society for Stereotactic and Functional Neurosurgery, European Society for Stereotactic and Functional Neurosurgery, Asian-Australasian Society for Stereotactic Functional Neurosurgery and the South and Latin American Society for Stereotactic and Functional Neurosurgery. Subsequent statistical and thematic analysis was performed on the data obtained.
Of 881 surveys distributed, 106 were returned (12.8%). Eighty-two percent of functional neurosurgeon respondents were fellowship trained, with movement disorders and pain making up the majority of their practice. Psychiatric indications are the most frequently treated conditions for 34% of survey respondents, and over half of participants (51%) perform epilepsy surgery. Of the psychiatric conditions, obsessive-compulsive disorder and depression are the most common disorders treated. The majority of respondents (90%) felt optimistic about the future of NPD. Two thirds cited the reluctance of psychiatrists to refer patients as the greatest obstacle facing the field, and a majority reported that a cultural stigma surrounding psychiatric diseases exists in their community. In response to hypothetical situations involving cognitive and personality enhancement, opinions varied, but the majority opposed enhancement interventions. Regional variations were examined as well and uncovered distinct attitudinal differences depending on geographic location.
Surgery for psychiatric conditions is an expanding field within functional neurosurgery. The opinions of international functional neurosurgeons were largely in line with those of their North American colleagues. Optimism regarding the future of NPD predominates, and future editions of this survey can be used to track the evolution of neurosurgeons' attitudes towards NPD and neuroenhancement.
全球范围内，对精神疾病神经外科手术（NPD）的关注日益增加。我们之前报告了一项对北美功能性神经外科医生的调查结果，该调查评估了对NPD的总体态度以及该领域的未来发展方向。
本研究的目的是在我们之前工作的基础上进行拓展，及时了解全球执业功能性神经外科医生对NPD的态度。我们衡量功能性神经外科的总体和区域趋势，特别关注针对精神和情绪的手术，同时探索该领域的未来前景。
我们设计了一项在线调查，并以电子方式分发给以下国际组织的881名成员：世界立体定向和功能性神经外科学会、欧洲立体定向和功能性神经外科学会、亚洲-澳大拉西亚立体定向功能性神经外科学会以及南美和拉丁美洲立体定向和功能性神经外科学会。随后对获得的数据进行了统计和主题分析。
在分发的881份调查问卷中，有106份被退回（12.8%）。82%的功能性神经外科医生受访者接受过专科培训，其业务主要集中在运动障碍和疼痛方面。34%的调查受访者将精神科适应症作为最常治疗的疾病，超过一半的参与者（51%）进行癫痫手术。在精神疾病中，强迫症和抑郁症是最常见的治疗疾病。大多数受访者（90%）对NPD的未来感到乐观。三分之二的人认为精神科医生不愿转诊患者是该领域面临的最大障碍，大多数人报告说他们所在社区存在围绕精神疾病的文化耻辱感。对于涉及认知和个性增强的假设情况，意见不一，但大多数人反对增强干预措施。我们还研究了区域差异，发现不同地理位置存在明显的态度差异。
精神疾病手术是功能性神经外科领域中一个不断发展的领域。国际功能性神经外科医生的意见在很大程度上与他们的北美同行一致。对NPD未来的乐观情绪占主导地位，本调查的未来版本可用于跟踪神经外科医生对NPD和神经增强态度的演变。
