Effective Deep Brain Stimulation for Obsessive-Compulsive Disorder Requires Clinical Expertise.

摘要: Background: Deep brain stimulation (DBS) is an innovative treatment for severe obsessive-compulsive disorder (OCD). Electrodes implanted in specific areas allow clinicians to directly modulate neural activity. DBS affects symptomatology a completely different way than established forms of OCD, such as psychotherapy or medication. Objective: To understand the process improvement with patients OCD. Methods: By means open-ended interviews and participant observation we explore how expert involved post-operative optimization evaluate effects. Results: Evaluating effect interactive context-sensitive that gradually unfolds over time requires integration sources knowledge. Clinicians direct toward critical point where they sense are being moved regard behavior, emotion, active engagement, opening up possibilities additional cognitive behavioral therapy (CBT). Discussion: Based on theoretical framework radical embodied science (RECS), assume clinical expertise manifests itself pattern interaction between patient clinician. clinician, this reflects patient’s openness action (“affordances”) offered by their environment. OCD patients’ can be understood change The threshold engage activities decreased broader range daily life therapeutic becomes attractive. Movement improvement.