Literature DB >> 26225215

Participants' Perceptions of Deep Brain Stimulation Research for Treatment-Resistant Depression: Risks, Benefits, and Therapeutic Misconception.

Yan Leykin1, Paul P Christopher2, Paul E Holtzheimer3, Paul S Appelbaum4, Helen S Mayberg3, Sarah H Lisanby5, Laura B Dunn1.   

Abstract

BACKGROUND: Deep brain stimulation (DBS) for treatment-resistant depression (TRD) is the focus of great interest and numerous studies. Given the state of this research, the risks of DBS, the uncertainty of direct benefits, and the potential for therapeutic misconception (TM), examination of research participants' perspectives is critical to addressing concerns about the adequacy of consent among people with TRD.
METHODS: Among 31 participants considering DBS studies at two sites, self-report questionnaires were used to examine three dimensions of TM (eight true/false items). Additional Likert-scale items assessed perceptions of risks, potential benefits, and altruistic motivations.
RESULTS: Participants correctly identified the surgery itself as the riskiest study procedure, although only four participants rated the surgery as "high risk." Most participants rated the entire DBS study as "moderate" or lower risk. Participants rated the likelihood of others benefiting in the future more strongly than they did the likelihood of personal benefit. Participants held positive attitudes toward research, and were moderately altruistic. Nearly two-thirds of the 31 participants (64.5%) answered at least one of the true/false TM items incorrectly.
CONCLUSIONS: Individuals considering DBS studies for TRD demonstrated reasonable perceptions of risks and benefits, distinguished among procedural risks, and expressed hopes for personal benefit as well as altruism. Findings related to TM were mixed: Participants understood the experimental stage of DBS for depression and endorsed the possibility of no personal benefit, yet there was some evidence for TM. Although these findings are reassuring, investigators must nevertheless remain vigilant about identifying and addressing potential misconceptions.

Entities:  

Keywords:  informed consent; major depression; research benefits; research risks; therapeutic misconception

Year:  2011        PMID: 26225215      PMCID: PMC4516276          DOI: 10.1080/21507716.2011.627579

Source DB:  PubMed          Journal:  AJOB Prim Res        ISSN: 2150-7724


  52 in total

Review 1.  Diagnosis and definition of treatment-resistant depression.

Authors:  Maurizio Fava
Journal:  Biol Psychiatry       Date:  2003-04-15       Impact factor: 13.382

2.  Therapeutic misconception and the appreciation of risks in clinical trials.

Authors:  Charles W Lidz; Paul S Appelbaum; Thomas Grisso; Michelle Renaud
Journal:  Soc Sci Med       Date:  2004-05       Impact factor: 4.634

3.  Deep brain stimulation for treatment-resistant depression: follow-up after 3 to 6 years.

Authors:  Sidney H Kennedy; Peter Giacobbe; Sakina J Rizvi; Franca M Placenza; Yasunori Nishikawa; Helen S Mayberg; Andres M Lozano
Journal:  Am J Psychiatry       Date:  2011-02-01       Impact factor: 18.112

4.  From prefrontal leukotomy to deep brain stimulation: the historical transformation of psychosurgery and the emergence of neuroethics.

Authors:  Joshua J Wind; Douglas E Anderson
Journal:  Neurosurg Focus       Date:  2008       Impact factor: 4.047

5.  Criteria for the ethical conduct of psychiatric neurosurgery clinical trials.

Authors:  Nir Lipsman; Mark Bernstein; Andres M Lozano
Journal:  Neurosurg Focus       Date:  2010-08       Impact factor: 4.047

6.  False hopes and best data: consent to research and the therapeutic misconception.

Authors:  P S Appelbaum; L H Roth; C W Lidz; P Benson; W Winslade
Journal:  Hastings Cent Rep       Date:  1987-04       Impact factor: 2.683

7.  Ethical Issues in Deep Brain Stimulation Research for Treatment-Resistant Depression: Focus on Risk and Consent.

Authors:  Laura B Dunn; Paul E Holtzheimer; Jinger G Hoop; Helen S Mayberg; Paul S Appelbaum
Journal:  AJOB Neurosci       Date:  2011

8.  Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys.

Authors:  Koen Demyttenaere; Ronny Bruffaerts; Jose Posada-Villa; Isabelle Gasquet; Viviane Kovess; Jean Pierre Lepine; Matthias C Angermeyer; Sebastian Bernert; Giovanni de Girolamo; Pierluigi Morosini; Gabriella Polidori; Takehiko Kikkawa; Norito Kawakami; Yutaka Ono; Tadashi Takeshima; Hidenori Uda; Elie G Karam; John A Fayyad; Aimee N Karam; Zeina N Mneimneh; Maria Elena Medina-Mora; Guilherme Borges; Carmen Lara; Ron de Graaf; Johan Ormel; Oye Gureje; Yucun Shen; Yueqin Huang; Mingyuan Zhang; Jordi Alonso; Josep Maria Haro; Gemma Vilagut; Evelyn J Bromet; Semyon Gluzman; Charles Webb; Ronald C Kessler; Kathleen R Merikangas; James C Anthony; Michael R Von Korff; Philip S Wang; Traolach S Brugha; Sergio Aguilar-Gaxiola; Sing Lee; Steven Heeringa; Beth-Ellen Pennell; Alan M Zaslavsky; T Bedirhan Ustun; Somnath Chatterji
Journal:  JAMA       Date:  2004-06-02       Impact factor: 56.272

9.  Assessment of therapeutic misconception in older schizophrenia patients with a brief instrument.

Authors:  Laura B Dunn; Barton W Palmer; Monique Keehan; Dilip V Jeste; Paul S Appelbaum
Journal:  Am J Psychiatry       Date:  2006-03       Impact factor: 18.112

10.  Appreciation of research information in patients with bipolar disorder.

Authors:  Sahana Misra; Robert Socherman; Peter Hauser; Linda Ganzini
Journal:  Bipolar Disord       Date:  2008-07       Impact factor: 6.744

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  11 in total

1.  The ethics of research on deep brain stimulation for depression: decisional capacity and therapeutic misconception.

Authors:  Carl Erik Fisher; Laura B Dunn; Paul P Christopher; Paul E Holtzheimer; Yan Leykin; Helen S Mayberg; Sarah H Lisanby; Paul S Appelbaum
Journal:  Ann N Y Acad Sci       Date:  2012-07-19       Impact factor: 5.691

2.  The effect of depression on the decision to join a clinical trial.

Authors:  Yan Leykin; Laura B Dunn; Ricardo F Muñoz
Journal:  J Consult Clin Psychol       Date:  2017-04-10

3.  Factors Influencing Perceived Helpfulness and Participation in Innovative Research: A Pilot Study of Individuals with and without Mood Symptoms.

Authors:  Jane Paik Kim; Tenzin Tsungmey; Maryam Rostami; Sangeeta Mondal; Max Kasun; Laura Weiss Roberts
Journal:  Ethics Behav       Date:  2021-09-22

4.  A qualitative study of key stakeholders' perceived risks and benefits of psychiatric electroceutical interventions.

Authors:  Laura Y Cabrera; Gerald R Nowak; Aaron M McCright; Eric Achtyes; Robyn Bluhm
Journal:  Health Risk Soc       Date:  2021-10-24

5.  Influence of Dispositional Optimism on Ethically Salient Research Perspectives: A Pilot Study.

Authors:  Jane Paik Kim; Sangeeta Mondal; Tenzin Tsungmey; Katie Ryan; Laura B Dunn; Laura Weiss Roberts
Journal:  Ethics Hum Res       Date:  2022-05

6.  An exploratory study of therapeutic misconception among incarcerated clinical trial participants.

Authors:  Paul P Christopher; Michael D Stein; Sandra A Springer; Josiah D Rich; Jennifer E Johnson; Charles W Lidz
Journal:  AJOB Empir Bioeth       Date:  2015-06-24

7.  Negative association of perceived risk and willingness to participate in innovative psychiatric research protocols.

Authors:  Tenzin Tsungmey; Jane Paik Kim; Laura B Dunn; Katie Ryan; Kyle Lane-McKinley; Laura Weiss Roberts
Journal:  J Psychiatr Res       Date:  2019-12-18       Impact factor: 4.791

8.  Deep brain stimulation for obsessive-compulsive disorder: Knowledge and concerns among psychiatrists, psychotherapists and patients.

Authors:  Matilda Naesström; Patric Blomstedt; Marwan Hariz; Owe Bodlund
Journal:  Surg Neurol Int       Date:  2017-12-06

9.  Autonomy in Depressive Patients Undergoing DBS-Treatment: Informed Consent, Freedom of Will and DBS' Potential to Restore It.

Authors:  Timo Beeker; Thomas E Schlaepfer; Volker A Coenen
Journal:  Front Integr Neurosci       Date:  2017-06-08

Review 10.  Informed Consent Decision-Making in Deep Brain Stimulation.

Authors:  Gabriele Mandarelli; Germana Moretti; Massimo Pasquini; Giuseppe Nicolò; Stefano Ferracuti
Journal:  Brain Sci       Date:  2018-05-11
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