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Cureus May 2024Obsessive-compulsive disorder (OCD) is a prevalent and debilitating mental health condition. This literature review examines the latest strategies in managing and... (Review)
Review
Obsessive-compulsive disorder (OCD) is a prevalent and debilitating mental health condition. This literature review examines the latest strategies in managing and treating OCD, with an emphasis on psychotherapy, pharmacological interventions, and neurosurgical options. A comprehensive literature search utilizing PubMed, Google Scholar, ClinicalKey, and Embase databases was conducted. Utilizing chosen keywords, the resulting articles were filtered based on inclusion and exclusion criteria. Included articles were used to discuss current research regarding OCD treatment and management. Findings reveal the efficacy and obstacles of treatments such as cognitive-behavioral therapy, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and evidence-based neurosurgical methods, offering a broad perspective on OCD management. We discuss the limitations of these established treatments and examine the innovative response of neurosurgery in treating patients with OCD. This review highlights the importance of individualized treatment plans and areas for future research.
PubMed: 38883111
DOI: 10.7759/cureus.60496 -
Neurology India Mar 2024With advances in technology, neurosurgical procedures are being examined for potential use in psychiatric conditions. However, the use of neurosurgical procedures in...
With advances in technology, neurosurgical procedures are being examined for potential use in psychiatric conditions. However, the use of neurosurgical procedures in psychiatry carries the baggage of memories of psychosurgery. Different neurosurgical techniques carry their characteristic safety, efficacy, and complication profile. The introduction of deep brain stimulation has generated a new interest in surgical treatment with a distinct advantage over lesioning procedures used in the past. In such a scenario, it is essential that an informed discussion takes place regarding the use of these neurosurgical procedures in psychiatric disorders such that patient safety, informed consent, regulatory requirements, and research are taken care of.
Topics: Humans; Psychosurgery; India; Deep Brain Stimulation; Mental Disorders; Neurosurgical Procedures
PubMed: 38817176
DOI: 10.4103/neuroindia.NI_1160_20 -
Case Reports in Neurology 2024The use of surgery for treatment of psychiatric conditions is a well-established strategy, especially in severe and resistant obsessive-compulsive disorder. Attractive...
INTRODUCTION
The use of surgery for treatment of psychiatric conditions is a well-established strategy, especially in severe and resistant obsessive-compulsive disorder. Attractive anatomical and functional targets for stereotactic surgery are reported in some studies. Surgery for treatment of psychiatric conditions in our nation and Arab world is obscured and hidden because of several social and cultural limitations, which should be overcome. We report here the first psychiatric neurosurgery in our nation and how we overcome such community limitation. This the first report of postoperative tremor.
CASE PRESENTATION
Young patient presented with severe and persistent obsessive-compulsive disorder resistant to all non-surgical modalities for several years. Stereotactic ablation surgery was done under local anaesthesia. Marked improvement in our obsessive-compulsive disorder patient after psychiatric neurosurgery with self-limited tremor was not reported before in the literature. The medications were the same before and immediate after surgery and this is not a drug-induced tremor. Postoperative YBOCS showed 90% of improvement.
CONCLUSION
Surgery-induced tremor could be a self-limited side effect after surgery in obsessive-compulsive disorder. Safety and efficacy should be promoted in our nation and Arab world. Society and cultural limitations should be overcome by further research studies, intervention, and activism in the field of mental health systems in our nation and Arab countries to improve awareness.
PubMed: 38751650
DOI: 10.1159/000538331 -
Vertex (Buenos Aires, Argentina) Apr 2024Includes appreciations of the work: Shock treatments, psychosurgery and other somatic treatments in psychiatry, by Lothar Kalinowsky and Paul Hoch, Editorial Cientifica...
Includes appreciations of the work: Shock treatments, psychosurgery and other somatic treatments in psychiatry, by Lothar Kalinowsky and Paul Hoch, Editorial Cientifica Médica, Barcelona, 1953.
Topics: Electroshock; Psychiatry; Behavior Therapy
PubMed: 38619993
DOI: 10.53680/vertex.v35i163.530 -
Advances and Technical Standards in... 2024Favorable clinical outcomes in adult and pediatric neurosurgical oncology generally depend on the extent of tumor resection (EOR). Maximum safe resection remains the...
Favorable clinical outcomes in adult and pediatric neurosurgical oncology generally depend on the extent of tumor resection (EOR). Maximum safe resection remains the main aim of surgery in most intracranial tumors. Despite the accuracy of intraoperative magnetic resonance imaging (iMRI) in the detection of residual intraoperatively, it is not widely implemented worldwide owing to enormous cost and technical difficulties. Over the past years, intraoperative ultrasound (IOUS) has imposed itself as a valuable and reliable intraoperative tool guiding neurosurgeons to achieve gross total resection (GTR) of intracranial tumors.Being less expensive, feasible, doesn't need a high level of training, doesn't need a special workspace, and being real time with outstanding temporal and spatial resolution; all the aforementioned advantages give a superiority for IOUS in comparison to iMRI during resection of brain tumors.In this chapter, we spot the light on the technical nuances, advanced techniques, outcomes of resection, pearls, and pitfalls of the use of IOUS during the resection of brain tumors.
Topics: Adult; Child; Humans; Ultrasonography; Hemispherectomy; Psychosurgery; Brain Neoplasms; Brain
PubMed: 38592531
DOI: 10.1007/978-3-031-53578-9_6 -
Chirurgie (Heidelberg, Germany) May 2024
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Treatment Outcome; Pneumonectomy; Psychosurgery
PubMed: 38587677
DOI: 10.1007/s00104-024-02073-2 -
British Journal of Hospital Medicine... Mar 2024
Topics: Humans; Psychosurgery; Surgical Flaps; Angiography; Ultrasonography, Doppler
PubMed: 38557092
DOI: 10.12968/hmed.2023.0388 -
Indian Journal of Psychological Medicine Nov 2023In the early 20 century, psychosurgery had gained worldwide popularity for treating mentally ill persons, especially in western countries. We attempt to chronicle its...
BACKGROUND
In the early 20 century, psychosurgery had gained worldwide popularity for treating mentally ill persons, especially in western countries. We attempt to chronicle its journey in the Mysore Government Mental Hospital (MGMH), now the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru.
METHODS
Archived case records and registers of patients admitted from 1939 to 1947 were reviewed to identify those who had undergone psychosurgery. Case records of the identified patients were assessed for clinical information, including the details of psychosurgery.
RESULTS
Among the patients, 107 had undergone psychosurgery, primarily leucotomy. Schizophrenia (51.5%) was the most common diagnosis in them, and 33.7% of all patients were reported to have improved. Yet, inconsistencies were found about the presence and degree of improvement. Possible side effects were not consistently documented.
CONCLUSION
Psychosurgery was adopted at the MGMH very soon following its introduction in the western world. However, ambiguity about its benefits and risks was noted in the current study.
PubMed: 38545541
DOI: 10.1177/02537176231154811 -
Movement Disorders Clinical Practice Apr 2024
Topics: Humans; Intracranial Aneurysm; Thalamus; Essential Tremor; Psychosurgery
PubMed: 38284308
DOI: 10.1002/mdc3.13989 -
Journal of Affective Disorders Apr 2024Obsessive compulsive disorder (OCD) is a disabling illness with a chronic course, yet data on long-term outcomes are scarce. This study aimed to examine the long-term...
BACKGROUND
Obsessive compulsive disorder (OCD) is a disabling illness with a chronic course, yet data on long-term outcomes are scarce. This study aimed to examine the long-term course of OCD in patients treated with different approaches (drugs, psychotherapy, and psychosurgery) and to identify predictors of clinical outcome by machine learning.
METHOD
We included outpatients with OCD treated at our referral unit. Demographic and neuropsychological data were collected at baseline using standardized instruments. Clinical data were collected at baseline, 12 weeks after starting pharmacological treatment prescribed at study inclusion, and after follow-up.
RESULTS
Of the 60 outpatients included, with follow-up data available for 5-17 years (mean = 10.6 years), 40 (67.7 %) were considered non-responders to adequate treatment at the end of the study. The best machine learning model achieved a correlation of 0.63 for predicting the long-term Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score by adding clinical response (to the first pharmacological treatment) to the baseline clinical and neuropsychological characteristics.
LIMITATIONS
Our main limitations were the sample size, modest in the context of traditional ML studies, and the sample composition, more representative of rather severe OCD cases than of patients from the general community.
CONCLUSIONS
Many patients with OCD showed persistent and disabling symptoms at the end of follow-up despite comprehensive treatment that could include medication, psychotherapy, and psychosurgery. Machine learning algorithms can predict the long-term course of OCD using clinical and cognitive information to optimize treatment options.
Topics: Humans; Treatment Outcome; Prospective Studies; Obsessive-Compulsive Disorder; Psychotherapy; Cognition
PubMed: 38246282
DOI: 10.1016/j.jad.2024.01.157