DBS in psychiatric disorders

A substantial proportion of patients with psychiatric disorders do not respond to psychotherapy or pharmacological intervention, and deep brain stimulation (DBS) offers the potential to treat these treatment-resistant patients. The complexity of psychiatric disorders, from diffuse neural correlates to symptom heterogeneity, makes determining DBS parameters challenging compared to movement disorders which have characteristic symptoms, such as tremor, that can be perceived by an external observer. This chapter begins with an exploration of the history that led to DBS for psychiatric disorders. Next, current indications for DBS are discussed as well as clinical trials for treatment-resistant obsessive compulsive disorder, major depressive disorder, and Tourette syndrome. The subsequent section focuses on the future of DBS for psychiatric disorders, emphasizing target and parameter optimization. The chapter concludes with a discussion on ethics.