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Effects of Deep Brain Stimulation on the Lived Experience of Obsessive-Compulsive Disorder Patients: In-Depth Interviews with 18 Patients.

de Haan S, Rietveld E, Stokhof M, Denys D - PLoS ONE (2015)

Bottom Line: In this paper, we present the results from this qualitative study.We subsequently provide an interpretation of these results.We end by making several concrete suggestions for further research.

View Article: PubMed Central - PubMed

Affiliation: Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands.

ABSTRACT
Deep Brain Stimulation (DBS) is a relatively new, experimental treatment for patients suffering from treatment-refractory Obsessive Compulsive Disorder (OCD). The effects of treatment are typically assessed with psychopathological scales that measure the amount of symptoms. However, clinical experience indicates that the effects of DBS are not limited to symptoms only: patients for instance report changes in perception, feeling stronger and more confident, and doing things unreflectively. Our aim is to get a better overview of the whole variety of changes that OCD patients experience during DBS treatment. For that purpose we conducted in-depth, semi-structured interviews with 18 OCD patients. In this paper, we present the results from this qualitative study. We list the changes grouped in four domains: with regard to (a) person, (b) (social) world, (c) characteristics of person-world interactions, and (d) existential stance. We subsequently provide an interpretation of these results. In particular, we suggest that many of these changes can be seen as different expressions of the same process; namely that the experience of anxiety and tension gives way to an increased basic trust and increased reliance on one's abilities. We then discuss the clinical implications of our findings, especially with regard to properly informing patients of what they can expect from treatment, the usefulness of including CBT in treatment, and the limitations of current measures of treatment success. We end by making several concrete suggestions for further research.

No MeSH data available.


Related in: MedlinePlus

Different fields of relevant affordances (Improved figure, reprinted from: [42]).
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pone.0135524.g001: Different fields of relevant affordances (Improved figure, reprinted from: [42]).

Mentions: Fig 1 gives a schematic depiction of different fields of relevant affordances. The ‘width’ refers to the range of affordances or the amount of action options that one perceives. The ‘depth’ of the field refers to the temporal aspect: one not only perceives the affordances that are immediately present here and now, but one is also (pre-reflectively) aware of future possibilities for action. That is, one may already anticipate the affordances on the horizon. Lastly, the ‘height’ of each of the affordances refers to the relevance or salience of this particular option. The different colours refer to variations in affective allure: something may be relevant because it is dangerous, or rather because it is highly attractive. It is a dynamic field: to the extent that either our concerns or the environment changes, the field of relevant affordances changes too [42].


Effects of Deep Brain Stimulation on the Lived Experience of Obsessive-Compulsive Disorder Patients: In-Depth Interviews with 18 Patients.

de Haan S, Rietveld E, Stokhof M, Denys D - PLoS ONE (2015)

Different fields of relevant affordances (Improved figure, reprinted from: [42]).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4552296&req=5

pone.0135524.g001: Different fields of relevant affordances (Improved figure, reprinted from: [42]).
Mentions: Fig 1 gives a schematic depiction of different fields of relevant affordances. The ‘width’ refers to the range of affordances or the amount of action options that one perceives. The ‘depth’ of the field refers to the temporal aspect: one not only perceives the affordances that are immediately present here and now, but one is also (pre-reflectively) aware of future possibilities for action. That is, one may already anticipate the affordances on the horizon. Lastly, the ‘height’ of each of the affordances refers to the relevance or salience of this particular option. The different colours refer to variations in affective allure: something may be relevant because it is dangerous, or rather because it is highly attractive. It is a dynamic field: to the extent that either our concerns or the environment changes, the field of relevant affordances changes too [42].

Bottom Line: In this paper, we present the results from this qualitative study.We subsequently provide an interpretation of these results.We end by making several concrete suggestions for further research.

View Article: PubMed Central - PubMed

Affiliation: Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands.

ABSTRACT
Deep Brain Stimulation (DBS) is a relatively new, experimental treatment for patients suffering from treatment-refractory Obsessive Compulsive Disorder (OCD). The effects of treatment are typically assessed with psychopathological scales that measure the amount of symptoms. However, clinical experience indicates that the effects of DBS are not limited to symptoms only: patients for instance report changes in perception, feeling stronger and more confident, and doing things unreflectively. Our aim is to get a better overview of the whole variety of changes that OCD patients experience during DBS treatment. For that purpose we conducted in-depth, semi-structured interviews with 18 OCD patients. In this paper, we present the results from this qualitative study. We list the changes grouped in four domains: with regard to (a) person, (b) (social) world, (c) characteristics of person-world interactions, and (d) existential stance. We subsequently provide an interpretation of these results. In particular, we suggest that many of these changes can be seen as different expressions of the same process; namely that the experience of anxiety and tension gives way to an increased basic trust and increased reliance on one's abilities. We then discuss the clinical implications of our findings, especially with regard to properly informing patients of what they can expect from treatment, the usefulness of including CBT in treatment, and the limitations of current measures of treatment success. We end by making several concrete suggestions for further research.

No MeSH data available.


Related in: MedlinePlus