Clinical use of brain stimulation in psychiatry - A motivated review: A lecture given at the Psy Congress September 6th 2018

Abstract

The combination of different treatment modalities has advanced psychiatric therapy, particularly for chronic or treatment-resistant psychiatric conditions. While the field has successfully integrated psychotherapy approaches, pharmacotherapy and rehabilitation, a novel group of brain stimulation techniques could offer new options augmenting classical psychiatric treatment. This review summarises basic principles of transcranial magnetic stimulation, transcranial direct current stimulation, electroconvulsive therapy and deep brain stimulation. Brain stimulation allows for targeted transient modulation of cortical network activity. Electroconvulsive therapy is already a standard treatment in chronic depression. Evidence suggests that noninvasive brain stimulation may be successfully combined with pharmacotherapy and psychotherapy in treatment resistant affective disorders or schizophrenia. In very severe cases, deep brain stimulation may help to relieve chronic depression or obsessive compulsive disorder. The application of brain stimulation in psychiatry is constantly evolving. The new methods hold potential for the field of psychiatry, including new treatment modalities to offer for patients and novel skills to acquire for psychiatrists.