As a psychiatrist and psychotherapist I read this article with great interest. However, my intention is not actually to comment substantially on the many questions raised by deep brain stimulation (DBS) but to provide a literature reference and give my reasons for doing so.
In his book “Tief im Hirn [Deep in the brain],” Helmut Dubiel, who had undergone DBS, published an impressive description of his treatment (1). Although in his case it was Parkinson’s disease that led to his having DBS, not a psychiatric disorder in the narrower sense, this book seems to me to be of great value for the article by Kuhn and colleagues. The doctor in charge of advice and treatment and the reader are given an exact description of the situation of a patient who is treated with DBS. The book is, of course, totally subjective, but also entirely credible and authentic.
However: is this science? An idea of the importance of patients’ (or “service users’”, as they are often referred to in English speaking countries) experiences came through in the 2009 schizophrenia guidelines from Britain’s National Institute for Health and Clinical Excellence. Tilmann Steinert comments that in spite of their formal evidence base, these official guidelines influencing English health policy contain substantial qualitative and subjective passages, for example, several detailed case histories giving patients’ own perspectives.
Dubiel’s book is such an example of a narrative contribution from a patient. In my opinion, the discussion around DBS would also be of benefit in psychiatric settings. In any case, we should be discussing the option.
Dubiel`s book is a fine example of a narrative contribution from a patient. In my opinion, the discussion around DBS would benefit from this in psychiatric illness, too. In any case, we should be discussing the option
Dr. med. Maria Rave-Schwank
|1.||Dubiel H: Tief im Hirn, München: Kunstmann Verlag, 2006.|
|2.||Steinert T: Update der britischen Schizophrenie-Leitlinien: keine leichte Kost, aber ein Meilenstein. Psychiat Prax 2009; 401–4. MEDLINE|
|3.||Kuhn J, Gründler TOJ, Lenartz D, Sturm V, Klosterkötter J, Huff W: Deep brain stimulation for psychiatric disorders [Tiefe Hirnstimulation bei psychiatrischen Erkrankungen]. Dtsch Arztebl Int 2010; 107(7): 105–13. VOLLTEXT|