Deep brain stimulation for obsessive–compulsive disorder: a crisis of access

Congratulations Drs. Foote and Okun on the publication of “Deep brain stimulation for obsessive–compulsive disorder: a crisis of access,” in the July 15th issue of Nature Medicine.

Deep brain stimulation is an effective treatment for obsessive–compulsive disorder but is rarely used. Action is needed by psychologists, psychiatrists and insurers so that patients with otherwise intractable cases can receive this therapy to improve their mental health.

Deep brain stimulation (DBS) is an approved therapy for obsessive–compulsive disorder (OCD), but it is rarely used despite its efficacy, which deprives people of effective treatment. OCD is characterized by distressing thoughts (obsessions) and repetitive mental or behavioral acts (compulsions). OCD affects 2–3% of the worldwide population and may cause substantial disability and adversely affect quality of life. First-line treatment consists of exposure and response prevention via cognitive–behavioral therapy (CBT) and pharmacotherapy, most commonly serotonin-reuptake inhibitors. OCD tends to be chronic and persistent, and impairment is common, despite use of the best medical therapy. Indeed, a large number of patients with severe OCD will not respond to these conventional therapies1.