• Thomas E Schläpfer, Andreas Meyer-Lindenberg, Matthis Synofzik, Veerle Visser-Vandewalle, Jürgen Voges, and Volker A Coenen.
• Division of Interventional Biological Psychiatry, Department of Psychiatry and Psychotherapy, University Hospital Freiburg; Division of Experimental Psychiatric Stimulation Techniques of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN), Psychosomatik und Nervenheilkunde e. V. Berlin; Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Mannheim Medical Faculty; Center of Neurology, The Hertie Institute for Clinical Brain Research, Clinic of Neurology at the University Hospital Tübingen; German Center of Neurodegenerative Diseases (DZNE), Tübingen; Clinic for Stereotaxy and Functional Neurosurgery, University Hospital Cologne; University Department of Stereotactic Neurosurgery, Universitätsklinikum Magdeburg; Medical Center-University of Freiburg, Department of Stereotactic and Functional Neurosurgery, Department of Neurosurgery.
• Dtsch Arztebl Int. 2021 Jan 22; 118 (3): 31-36.

BackgroundDrugs, psychotherapy, and other treatment modalities are effective for many patients with mental illness. Nonetheless, many patients do not achieve a total remission with the currently available interventions, and the recurrence rates are high. As part of the ongoing search for further treatment options for refractory disorders, there is renewed interest in focal neuromodulatory techniques, including invasive ones, and deep brain stimulation (DBS) in particular.MethodsIn this review article, a group consisting of neurosurgeons, psychiatrists, and one practicing ethicist/neurologist summarizes the main aspects of the use of DBS to treat mental illness and offers recommendations on its indications and practical implementation.ResultsThe efficacy of DBS against mental illness has not been confirmed in the randomized, controlled trials (RCTs) that have been published to date. This may be because the follow-up times were too short. In contrast to the negative RCTs, case series have indeed shown a positive effect of DBS on severe depression, but this effect can only be seen several months after the operation.ConclusionDBS may be a therapeutic option for selected patients with otherwise intractable mental illness. Patients should only be treated in the setting of clinical trials. RCTs with longer follow-up times must be conducted in order to substantiate, if possible, the promising evidence that has been found in case series.

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