Characteristics of patients who received deep brain stimulation in obsessive-compulsive disorder versus major depressive disorder

J Psychiatr Res. 2021 Apr:136:384-387. doi: 10.1016/j.jpsychires.2021.02.032. Epub 2021 Feb 16.

Abstract

Objective: Deep brain stimulation (DBS) is cleared for treatment of obsessive-compulsive disorder (OCD) but is an investigational treatment for major depressive disorder (MDD). The aim of this study is to compare the characteristics of patients who received DBS as part of standard care for OCD versus those who received it a part of a research protocol for MDD.

Methods: The inpatient sample (N = 110) was drawn from the 2012-2014 Nationwide Inpatient Sample (NIS), and included adults with a primary discharge diagnosis of MDD (N = 50) or OCD (N = 60) and primary procedure of DBS. The study compared various patient demographics, clinical, hospital and insurance variables between the 2 groups.

Results: DBS recipients with OCD were younger compared to those with MDD. DBS recipients with MDD tended to be from high-income families compared to those with OCD. DBS patients with MDD were in the South region, while DBS patients with OCD were in the Midwest and South regions of the United States (US). The study did not detect a significant difference in the length of stay and total charges among DBS recipients with OCD versus MDD.

Conclusions: DBS patients with MDD are typically older with more financial resources compared to those with OCD. DBS is federally cleared for OCD, but not for MDD, demonstrating the need for further investigation to establish DBS as a federally cleared treatment for difficult to treat MDD if well-powered randomized trials further support its use.

Keywords: Deep brain stimulation; Healthcare utilization; Major depressive disorder (MDD); Obsessive-compulsive disorder (OCD); Treatment-resistant MDD; Treatment-resistant OCD.

MeSH terms

  • Adult
  • Deep Brain Stimulation*
  • Depressive Disorder, Major* / therapy
  • Humans
  • Inpatients
  • Obsessive-Compulsive Disorder* / therapy
  • Patient Discharge