Effectiveness, Timing and Procedural Aspects of Cognitive Behavioral Therapy after Deep Brain Stimulation for Therapy-Resistant Obsessive Compulsive Disorder: A Systematic Review
<i>Background and aim:</i> Deep brain stimulation (DBS) is an effective treatment for patients with severe therapy-resistant obsessive-compulsive disorder (OCD). After initiating DBS many patients still require medication and/or behavioral therapy to deal with persisting symptoms and hab...
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| Format: | Article |
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MDPI AG
2020-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/8/2383 |
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| author | Meltem Görmezoğlu Tim Bouwens van der Vlis Koen Schruers Linda Ackermans Mircea Polosan Albert F.G. Leentjens |
| author_facet | Meltem Görmezoğlu Tim Bouwens van der Vlis Koen Schruers Linda Ackermans Mircea Polosan Albert F.G. Leentjens |
| author_sort | Meltem Görmezoğlu |
| collection | DOAJ |
| description | <i>Background and aim:</i> Deep brain stimulation (DBS) is an effective treatment for patients with severe therapy-resistant obsessive-compulsive disorder (OCD). After initiating DBS many patients still require medication and/or behavioral therapy to deal with persisting symptoms and habitual behaviors. The clinical practice of administering postoperative cognitive behavioral therapy (CBT) varies widely, and there are no clinical guidelines for this add-on therapy. The aim of this review is to assess the efficacy, timing and procedural aspects of postoperative CBT in OCD patients treated with DBS. <i>Method:</i> Systematic review of literature. <i>Results:</i> The search yielded 5 original studies, one case series and three reviews. Only two clinical trials have explicitly focused on the effectiveness of CBT added to DBS in patients with therapy-resistant OCD. These two studies both showed effectiveness of CBT. However, they had a distinctly different design, very small sample sizes and different ways of administering the therapy. Therefore, no firm conclusions can be drawn or recommendations made for administering CBT after DBS for therapy-resistant OCD. <i>Conclusion:</i> The effectiveness, timing and procedural aspects of CBT added to DBS in therapy-resistant OCD have hardly been studied. Preliminary evidence indicates that CBT has an added effect in OCD patients being treated with DBS. Since the overall treatment effect is the combined result of DBS, medication and CBT, future trials should be designed in such a way that they allow quantification of the effects of these add-on therapies in OCD patients treated with DBS. Only in this way information can be gathered that contributes to the development of an algorithm and clinical guidelines for concomittant therapies to optimize treatment effects in OCD patients being treated with DBS. |
| first_indexed | 2024-03-10T18:12:06Z |
| format | Article |
| id | doaj.art-785a7b1a8ade410ca93020d275abfe6f |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T18:12:06Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-785a7b1a8ade410ca93020d275abfe6f2023-11-20T07:59:55ZengMDPI AGJournal of Clinical Medicine2077-03832020-07-0198238310.3390/jcm9082383Effectiveness, Timing and Procedural Aspects of Cognitive Behavioral Therapy after Deep Brain Stimulation for Therapy-Resistant Obsessive Compulsive Disorder: A Systematic ReviewMeltem Görmezoğlu0Tim Bouwens van der Vlis1Koen Schruers2Linda Ackermans3Mircea Polosan4Albert F.G. Leentjens5Department of Psychiatry, Ondokuz Mayıs University, 55270 Samsun, TurkeyDepartment of Neurosurgery, Maastricht University Medical Centre, 6229 Maastricht, The NetherlandsDepartment of Psychiatry and Neuropsychology, Maastricht University Medical Center, 6229 Maastricht, The NetherlandsDepartment of Neurosurgery, Maastricht University Medical Centre, 6229 Maastricht, The NetherlandsGrenoble Institute of Neurosciences, University of Grenoble Alpes, 38058 Grenoble, FranceDepartment of Psychiatry and Neuropsychology, Maastricht University Medical Center, 6229 Maastricht, The Netherlands<i>Background and aim:</i> Deep brain stimulation (DBS) is an effective treatment for patients with severe therapy-resistant obsessive-compulsive disorder (OCD). After initiating DBS many patients still require medication and/or behavioral therapy to deal with persisting symptoms and habitual behaviors. The clinical practice of administering postoperative cognitive behavioral therapy (CBT) varies widely, and there are no clinical guidelines for this add-on therapy. The aim of this review is to assess the efficacy, timing and procedural aspects of postoperative CBT in OCD patients treated with DBS. <i>Method:</i> Systematic review of literature. <i>Results:</i> The search yielded 5 original studies, one case series and three reviews. Only two clinical trials have explicitly focused on the effectiveness of CBT added to DBS in patients with therapy-resistant OCD. These two studies both showed effectiveness of CBT. However, they had a distinctly different design, very small sample sizes and different ways of administering the therapy. Therefore, no firm conclusions can be drawn or recommendations made for administering CBT after DBS for therapy-resistant OCD. <i>Conclusion:</i> The effectiveness, timing and procedural aspects of CBT added to DBS in therapy-resistant OCD have hardly been studied. Preliminary evidence indicates that CBT has an added effect in OCD patients being treated with DBS. Since the overall treatment effect is the combined result of DBS, medication and CBT, future trials should be designed in such a way that they allow quantification of the effects of these add-on therapies in OCD patients treated with DBS. Only in this way information can be gathered that contributes to the development of an algorithm and clinical guidelines for concomittant therapies to optimize treatment effects in OCD patients being treated with DBS.https://www.mdpi.com/2077-0383/9/8/2383deep brain stimulationobsessive compulsive disordercognitive behavioral therapy |
| spellingShingle | Meltem Görmezoğlu Tim Bouwens van der Vlis Koen Schruers Linda Ackermans Mircea Polosan Albert F.G. Leentjens Effectiveness, Timing and Procedural Aspects of Cognitive Behavioral Therapy after Deep Brain Stimulation for Therapy-Resistant Obsessive Compulsive Disorder: A Systematic Review Journal of Clinical Medicine deep brain stimulation obsessive compulsive disorder cognitive behavioral therapy |
| title | Effectiveness, Timing and Procedural Aspects of Cognitive Behavioral Therapy after Deep Brain Stimulation for Therapy-Resistant Obsessive Compulsive Disorder: A Systematic Review |
| title_full | Effectiveness, Timing and Procedural Aspects of Cognitive Behavioral Therapy after Deep Brain Stimulation for Therapy-Resistant Obsessive Compulsive Disorder: A Systematic Review |
| title_fullStr | Effectiveness, Timing and Procedural Aspects of Cognitive Behavioral Therapy after Deep Brain Stimulation for Therapy-Resistant Obsessive Compulsive Disorder: A Systematic Review |
| title_full_unstemmed | Effectiveness, Timing and Procedural Aspects of Cognitive Behavioral Therapy after Deep Brain Stimulation for Therapy-Resistant Obsessive Compulsive Disorder: A Systematic Review |
| title_short | Effectiveness, Timing and Procedural Aspects of Cognitive Behavioral Therapy after Deep Brain Stimulation for Therapy-Resistant Obsessive Compulsive Disorder: A Systematic Review |
| title_sort | effectiveness timing and procedural aspects of cognitive behavioral therapy after deep brain stimulation for therapy resistant obsessive compulsive disorder a systematic review |
| topic | deep brain stimulation obsessive compulsive disorder cognitive behavioral therapy |
| url | https://www.mdpi.com/2077-0383/9/8/2383 |
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