Prospective long-term follow-up of 44 patients who received cingulotomy for treatment-refractory obsessive-compulsive disorder.
OBJECTIVE
Long-term outcome associated with cingulotomy for obsessive-compulsive disorder (OCD) was prospectively assessed. Findings are reported for 18 patients previously described in 1995 and for 26 new patients.


METHODS
An open preoperative and follow-up assessment was conducted at multiple time points for 44 patients undergoing one or more cingulotomies for treatment-refractory OCD. The patients were assessed by using the Structured Clinical Interview for DSM-III-R preoperatively and with the Yale-Brown Obsessive Compulsive Scale, the Beck Depression Inventory, and the Sickness Impact Profile both preoperatively and at all follow-up assessments. The patients completed clinical global improvement scales at all follow-up assessments.


RESULTS
At mean follow-up of 32 months after one or more cingulotomies, 14 patients (32%) met criteria for treatment response and six others (14%) were partial responders. Thus, 20 patients (45%) were at least partial responders at long-term follow-up after one or more cingulotomies. Few adverse effects were reported.


CONCLUSIONS
Thirty-two percent to 45% of patients previously unresponsive to medication and behavioral treatments for OCD were at least partly improved after cingulotomy. Cingulotomy remains a viable treatment option for patients with severe treatment-refractory OCD.
Dougherty
Darin D
DD
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Baer
Lee
L
Cosgrove
G Rees
GR
Cassem
Edwin H
EH
Price
Bruce H
BH
Nierenberg
Andrew A
AA
Jenike
Michael A
MA
Rauch
Scott L
SL
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006179:Gyrus Cinguli / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000523:psychology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D018434:Sickness Impact Profile; D016896:Treatment Outcome