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Backgroud: In cases of severe treatment refractory obsessive-compulsive disorder (OCD), neurosurgical therapy can be applied, in two possible ways: anterior capsulotomy (AC) or deep brain stimulation (DBS). Objectives: This study aims to clarify whether surgical intervention is able to reduce obsessions and compulsions, using the Yale-Brown obsessive-compulsive scale (Y-BOCS). Design and setting: we performed a systematic review of studies available in four databases from 2000 to 2020. Methods: the serch was performed using variations of descriptors: “OCD”, “DBS” and “anterior capsulotomy”; only studies that respect the eligibility criteria predefined were included. Results: After online research, 9 eligible articles were identified, containing a total of 129 patients. Global Y-BOCS score reduction percentage was 47,81% and global responders percentage at 68,1%. The Y-BOCS reduction percentage by DBS was 43,18% and clinical response rate was 62,33%, with two remission cases. In comparison, AC led to a reduction of 52.25%; a response rate of 73.88% and 5 remission cases. The adverse effects seen were varied and depend on the type of procedure and each individual. Conclusion: The data collected support the hypothesis that surgical intervention reduces the Y-BOCS scale and consequently the symptoms of OCD; it also generates a significant clinical response. DBS showed less clinical response and remission, but it has the advantage of being a reversible therapy and producing fewer adverse effects; but it does have some relative disadvantages in relation to AC, which may be overcome by technological advances. |
