Deep Brain Stimulation for Psychiatric Disorders

Psychiatric disorders are common and are responsible for significant human morbidity and mortality. Although current treatment approaches are effective for many patients, a substantial minority remains treatment-resistant. Advances in the understanding of how disturbances in brain networks lead to psychiatric manifestations and the observation of the effectiveness of deep brain stimulation (DBS) in disorders of motor circuitry such as Parkinson’s disease and dystonia has motivated its investigation in other circuit-based disorders. This chapter reviews the clinical experience of DBS in the major mood and anxiety disorders, namely major depression and obsessive–compulsive disorder. We review the circuitry of these conditions, as well as target selection for these and other emerging DBS indications in psychiatry. Neuromodulation is becoming an increasingly important component of the care of psychiatric patients, and DBS, in properly selected patients, and guided by an expert multi-disciplinary team, may offer promise for patients with few treatment alternatives.