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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO480

Current clinical management practices for surgical treatments in treatment-refractory obsessive-compulsive disorder: A WSSFN survey of nine international centers

CURRENT CLINICAL MANAGEMENT PRACTICE OF SURGICAL TREATMENTS FOR TREATMENT-REFRACTORY OBSESSIVE COMPULSIVE DISORDER (OCD): A SURVEY OF NINE INTERNATIONAL CENTERS FROM THE WSSFN

International centers performing surgical interventions for treatment-refractory obsessive-compulsive disorder are largely converging on similar practices regarding patient selection, definitions of treatment resistance, and multidisciplinary follow-up.

The aim was to identify differences in clinical practice among specialized centers offering deep brain stimulation (DBS) and stereotactic ablation for severe, treatment-refractory obsessive-compulsive disorder (OCD). As part of an initiative by the Psychiatric Surgery Task Force of the World Society for Stereotactic and Functional Neurosurgery (WSSFN), a structured survey was distributed to centers with multidisciplinary psychiatric neurosurgery programs, and nine centers completed it. The survey covered the interventions offered (DBS and ablative techniques using Gamma Knife, laser interstitial thermal therapy, radiofrequency thermoablation, or MR-guided focused ultrasound), program characteristics, clinical volume, neuroanatomical targets, eligibility criteria, management of psychiatric and medical comorbidities, definitions of treatment resistance, referral and review processes, postoperative follow-up, and rehabilitation strategies. Participating centers were located in Canada, the United States, France, the Netherlands, Germany, Sweden, Belgium, and India. The findings indicated that the nine programs had collective experience with approximately 500 patients with severe, treatment-refractory OCD treated with DBS or ablative techniques. DBS targets included the nucleus accumbens, the anterior limb of the internal capsule, the superolateral medial forebrain bundle, the anteromedial subthalamic nucleus, and the bed nucleus of the stria terminalis; some centers also performed capsulotomy or cingulotomy. Across centers, treatment resistance was defined as persistent severe symptoms and functional impairment following inadequate responses to multiple pharmacological interventions (e.g., at least three adequate SSRI trials) and psychotherapeutic interventions (e.g., CBT/exposure and response prevention). In conclusion, inclusion and exclusion criteria were generally consistent across centers; the emphasis placed by all centers on structured follow-up and postoperative psychotherapy suggests international convergence in patient selection and multidisciplinary care pathways.

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