Japanese Psychiatrists' Perceptions of Surgical Treatment for Treatment-Resistant Obsessive Compulsive Disorder: A Nationwide Survey

AimSurgical interventions such as deep brain stimulation (DBS) have demonstrated efficacy for severe treatment-resistant obsessive-compulsive disorder (TR-OCD) internationally, but surgical treatment has yet to be implemented in Japan. One factor hindering progress is uncertainty regarding domestic clinical demand, so a nationwide survey of psychiatrists was conducted to clarify their perceptions of OCD surgery. We analysed the data with the aim of identifying factors associated with the acceptance of surgical interventions. MethodsA web-based survey was conducted targeting board-certified psychiatrists in Japan. A total of 212 psychiatrists participated, responding to 10 multiple-choice questions assessing their awareness, perceived need, and expectations regarding DBS. Descriptive statistics, correlation analysis, and multiple linear regression models were used to examine associations between key variables. ResultsPerceived inadequacy of standard treatments alone for severe TR-OCD was strongly associated with perceived need for new treatment options including surgical interventions and with justifiability of surgical treatment. Clinical experience with OCD (Q3) showed a modest positive association with surgical acceptability, whereas greater experience with TR-OCD (Q4) corresponded to more cautious attitudes. Awareness of overseas surgical treatment (Q5) was associated with stronger recognition of treatment limitations and greater acceptance of surgical options. ConclusionsPsychiatrists support for OCD surgery in Japan is primarily driven by perceived unmet clinical needs and awareness of international surgical practices. Enhancing education, addressing ethical concerns, and generating domestic clinical evidence may facilitate the responsible introduction of surgical treatment for TR-OCD.