Applicants for stereotactic neurosurgery for psychiatric disorders: role of the Flemish advisory board

Objective: Research on stereotactic neurosurgery for psychiatric disorders (SNPD) is rapidly evolving. Knowledge on patients undergoing SNPD is of crucial importance. We describe applicants for SNPD and examine the necessity for a multidisciplinary advisory board. Method: Summary of the current practice of the Flemish advisory board (SNPD committee) and analysis of a questionnaire investigating the attitude of clinicians on SNPD. Results: In 7 years, 91 applications were submitted, nine patients did not fulfill diagnostic criteria for OCD, 65 patients received a positive recommendation, 50 SNPD procedures were performed. The prevalence of SNPD in the current year in Belgium is 0.6/million inhabitants. Ninety-seven per cent of clinicians consider the expertise and advice of the SNPD committee essential for indication setting. Forty-four percent of clinicians consider referral of a patient for capsulotomy, 82% for electrical brain stimulation. Conclusion: Neurosurgery is exclusively considered for severe, treatment-refractory psychiatric disorders. Clinicians consider the SNPD committee essential in the decision-making process prior to intervention.