Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.
Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA.
J Child Adolesc Psychopharmacol. 2021 Mar;31(2):109-117. doi: 10.1089/cap.2020.0166. Epub 2021 Feb 2.
The present study aims to understand perceptions of deep brain stimulation (DBS) for severe obsessive-compulsive disorder (OCD) in adolescents among two groups: parents of children with a history of OCD and adults with a history of OCD. Two hundred sixty participants completed a questionnaire exploring their treatment history, relevant symptom severity, DBS knowledge, and DBS attitudes using an acceptability scale and a series of statements indicating levels of willingness or reluctance to consider DBS for adolescents with severe OCD or severe epilepsy. Overall, participants found DBS to be fairly acceptable for adolescents with severe OCD, with 63% reporting at least 7/10 on a 0-10 acceptability Likert scale. Respondents were more willing to consider DBS for epilepsy than for OCD. Several factors were associated with greater willingness to consider DBS for OCD, including familiarity with DBS, the presence of suicidal thoughts, assurances of daily functioning improvements, and assurances of substantial symptom reduction. Concerns about safety, personality changes, and long-term effects on the body were associated with greatest reluctance to consider DBS for OCD. Our findings support the importance of increasing parents' familiarity with DBS, monitoring factors participants identified as most important to their DBS perceptions in future DBS research, and communicating benefits and risks clearly. We also highlight the need for further research on perceptions of DBS for severe and refractory OCD in adolescents.
本研究旨在了解两组人群对深部脑刺激(DBS)治疗青少年重度强迫症(OCD)的看法:一组是有 OCD 病史的儿童的父母,另一组是有 OCD 病史的成年人。260 名参与者完成了一份调查问卷,该问卷通过可接受性量表和一系列表明对接受青少年重度 OCD 或重度癫痫患者接受 DBS 治疗的意愿或不情愿程度的陈述,探讨了他们的治疗史、相关症状严重程度、DBS 知识和 DBS 态度。总体而言,参与者认为 DBS 对青少年重度 OCD 是相当可接受的,有 63%的人在 0-10 分的可接受性李克特量表上至少得 7 分。受访者更愿意考虑为癫痫患者进行 DBS,而不是为 OCD 患者。一些因素与更愿意考虑为 OCD 患者进行 DBS 治疗有关,包括对 DBS 的熟悉程度、自杀念头的存在、保证日常功能改善和保证症状大幅减轻。对安全性、人格改变和对身体的长期影响的担忧与最不愿意考虑为 OCD 患者进行 DBS 治疗有关。我们的研究结果支持提高父母对 DBS 的熟悉程度的重要性,在未来的 DBS 研究中监测参与者认为对 DBS 看法最重要的因素,并清楚地沟通益处和风险。我们还强调需要进一步研究青少年重度和难治性 OCD 对 DBS 的看法。