{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:05:58Z","timestamp":1789113958213,"version":"build-2803163510"},"reference-count":30,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The aim of this study was to investigate the outcome of neurosurgery for mental illness in a cohort of Egyptian\/Arab patients with treatment-resistant obsessive-compulsive disorder (OCD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Sixteen patients were recruited from various psychiatric clinics. All participants met DSM-5 criteria for OCD and had failed extensive trials of psychiatric medications and psychotherapies. Eligibility criteria focused on significant distress and functional impairment, as well as a Yale-Brown Obsessive Compulsive Scale (YBOCS) score greater than 30. Patients underwent either cingulotomy or capsulotomy and were followed monthly beginning immediately after surgery. Follow-up assessment evaluated OCD symptom severity, depression, anxiety, functional status, and both immediate and delayed postoperative adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At the most recent follow-up (median: 19, range: 6 months \u2013 25 months), 56.25% (9\/16) of patients achieved at least a partial response, including 8 responders and 1 partial responder. Significant reductions in YBOCS, Beck Depression Inventory (BDI), and Hamilton Anxiety Rating Scale scores were recorded, suggesting that psychosurgery may be associated with improvement in OCD symptoms. However, because this was a noncontrolled study, causality between surgery and clinical improvement cannot be established. Immediate adverse effects were mild, transient, and observed in 37.5% (6\/16) of patients. Delayed adverse effects were reported by 68.75% (11\/16) of the total cohort and were predominantly characterized by recurrence of the initial OCD symptoms (9\/16), often accompanied by depressive symptoms. Notably, two-thirds of patients who experienced symptom relapse were subsequently managed successfully with pharmacotherapy and behavioral therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Both cingulotomy and capsulotomy may be associated with significant reductions in OCD symptom severity, as well as improvements in depression and anxiety among patients with treatment-resistant OCD. Although relapse of OCD symptoms during follow-up was common, close monthly monitoring immediately after surgery and ongoing management were effective in restoring clinical improvement in many patients. As the first study of its kind conducted in Egypt and the Arab world, these findings also highlight the unique cultural challenges encountered in introducing psychiatric surgery within this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_250_2026","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T07:09:29Z","timestamp":1789110569000},"page":"517","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy, management of adverse effects and relapse forms after obsessive-compulsive disorder surgery: The first Egyptian and Arab cohort"],"prefix":"10.25259","volume":"17","author":[{"given":"Hussein","family":"Hamdi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Tanta University, Tanta, Egypt"},{"name":"Department of Neurosurgery, Al-Azhar University, Tanta, Egypt"},{"name":"Cyberknife Radiosurgery Center, Cairo, Egypt"},{"name":"Member of Executive Committee of Stereotactic and Functional Neurosurgery at World Federation of Neurological Societies, Central Office, Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hend","family":"Aref","sequence":"additional","affiliation":[{"name":"Psychiatry and Neurology Centre, Tanta, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Kamel","sequence":"additional","affiliation":[{"name":"Department of Neurology and Psychiatry, Tanta University, Tanta, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"10.25259\/SNI_250_2026\/ref-1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1744-859X-10-2","article-title":"Guidelines for rating global assessment of functioning (GAF)","volume":"10","author":"Aas","year":"2011","journal-title":"Ann Gen Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-2","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1001\/archpsyc.1995.03950170058008","article-title":"Cingulotomy for intractable obsessive-compulsive disorder. Prospective long-term follow-up of 18 patients","volume":"52","author":"Baer","year":"1995","journal-title":"Arch Gen Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-3","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/0006-3223(87)90080-1","article-title":"Treatment of psychiatric illness by stereotactic cingulotomy","volume":"22","author":"Ballantine","year":"1987","journal-title":"Biol Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-4","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1001\/archpsyc.1961.01710120031004","article-title":"An inventory for measuring depression","volume":"4","author":"Beck","year":"1961","journal-title":"Arch Gen Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-5","doi-asserted-by":"crossref","first-page":"77","DOI":"10.3171\/2015.1.JNS14681","article-title":"Dorsal anterior cingulotomy and anterior capsulotomy for severe, refractory obsessive-compulsive disorder: A systematic review of observational studies","volume":"124","author":"Brown","year":"2016","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_250_2026\/ref-6","first-page":"28","article-title":"The clinical global impressions scale: Applying a research tool in clinical practice","volume":"4","author":"Busner","year":"2007","journal-title":"Psychiatry (Edgmont)"},{"key":"10.25259\/SNI_250_2026\/ref-7","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1176\/ps.49.3.379","article-title":"Global functioning of inpatients with obsessive-compulsive disorder, schizophrenia, and major depression","volume":"49","author":"Calvocoressi","year":"1998","journal-title":"Psychiatr Serv"},{"key":"10.25259\/SNI_250_2026\/ref-8","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s41811-019-00065-3","article-title":"A study on the effectiveness of cognitive behavioural therapy for obsessive compulsive behaviour in Iraq: Lessons for cross-cultural practice","volume":"13","author":"Cucchi","year":"2020","journal-title":"Int J Cogn Ther"},{"key":"10.25259\/SNI_250_2026\/ref-9","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1176\/appi.ajp.159.2.269","article-title":"Prospective long-term follow-up of 44 patients who received cingulotomy for treatment-refractory obsessive-compulsive disorder","volume":"159","author":"Dougherty","year":"2002","journal-title":"Am J Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-10","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/B978-0-444-64076-5.00049-1","article-title":"Genetic susceptibility in obsessive-compulsive disorder","volume":"148","author":"Fernandez","year":"2018","journal-title":"Handb Clin Neurol"},{"key":"10.25259\/SNI_250_2026\/ref-11","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.psychres.2014.12.003","article-title":"Obsessive-compulsive disorder (OCD): Practical strategies for pharmacological and somatic treatment in adults","volume":"227","author":"Fineberg","year":"2015","journal-title":"Psychiatry Res"},{"key":"10.25259\/SNI_250_2026\/ref-12","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1001\/archpsyc.1989.01810110048007","article-title":"The yale-brown obsessive compulsive scale. I. Development, use, and reliability","volume":"46","author":"Goodman","year":"1989","journal-title":"Arch Gen Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-13","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/15564900802035268","article-title":"Cognitive restructuring: An Islamic perspective","volume":"3","author":"Hamdan","year":"2008","journal-title":"J Muslim Ment Health"},{"key":"10.25259\/SNI_250_2026\/ref-14","first-page":"99","article-title":"Surgery for obsessive-compulsive disorder and transient tremors as newly reported side effect: First psychiatric neurosurgery in Egypt","volume":"16","author":"Hamdi","year":"2024","journal-title":"Case Rep Neurol"},{"key":"10.25259\/SNI_250_2026\/ref-15","doi-asserted-by":"crossref","first-page":"1329748","DOI":"10.3389\/fpsyt.2024.1329748","article-title":"Variations in obsessive compulsive disorder symptomatology across cultural dimensions","volume":"15","author":"Hassan","year":"2024","journal-title":"Front Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-16","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1111\/j.1600-0447.1993.tb03356.x","article-title":"Treatment of obsessive-compulsive disorder by psychosurgery","volume":"87","author":"Hay","year":"1993","journal-title":"Acta Psychiatr Scand"},{"key":"10.25259\/SNI_250_2026\/ref-17","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1017\/S109285290000225X","article-title":"A review of the treatment for refractory obsessive-compulsive disorder: from medicine to deep brain stimulation","volume":"9","author":"Husted","year":"2004","journal-title":"CNS Spectr"},{"key":"10.25259\/SNI_250_2026\/ref-18","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1001\/archpsyc.1991.01810300060009","article-title":"Cingulotomy for refractory obsessive-compulsive disorder. A long-term follow-up of 33 patients","volume":"48","author":"Jenike","year":"1991","journal-title":"Arch Gen Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-19","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1192\/S0007125000297936","article-title":"Neurosurgical treatment of obsessive-compulsive disorder","volume":"35","author":"Jenike","year":"1998","journal-title":"Br J Psychiatry Suppl"},{"key":"10.25259\/SNI_250_2026\/ref-20","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1016\/j.biopsych.2020.01.006","article-title":"Maternal effects as causes of risk for obsessive-compulsive disorder","volume":"87","author":"Mahjani","year":"2020","journal-title":"Biol Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-21","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1038\/s41380-018-0054-0","article-title":"Evolution of gamma knife capsulotomy for intractable obsessive-compulsive disorder","volume":"24","author":"Miguel","year":"2019","journal-title":"Mol Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-22","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/0010-440X(94)90191-0","article-title":"Phenomenology of obsessive-compulsive disorder: A transcultural study","volume":"35","author":"Okasha","year":"1994","journal-title":"Compr Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-23","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1016\/S0272-7358(99)00003-3","article-title":"Mental health in the Middle East: An Egyptian perspective","volume":"19","author":"Okasha","year":"1999","journal-title":"Clin Psychol Rev"},{"key":"10.25259\/SNI_250_2026\/ref-24","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1080\/09540261.2024.2400143","article-title":"Mental health services in Egypt, the Middle East, and North Africa","volume":"37","author":"Okasha","year":"2025","journal-title":"Int Rev Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-25","article-title":"Personality Changes in Refractory Patients With Obsessive-Compulsive Disorder Submitted to Gamma Ventral Capsulotomy","author":"Paiva","year":"2016"},{"key":"10.25259\/SNI_250_2026\/ref-26","doi-asserted-by":"crossref","first-page":"216","DOI":"10.5539\/gjhs.v4n6p216","article-title":"Religious attitudes in adolescents with obsessive compulsive symptoms OCS and disorder OCD","volume":"4","author":"Rady","year":"2012","journal-title":"Glob J Health Sci"},{"key":"10.25259\/SNI_250_2026\/ref-27","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.biopsych.2017.11.034","article-title":"Gamma ventral capsulotomy in intractable obsessive-compulsive disorder","volume":"84","author":"Rasmussen","year":"2018","journal-title":"Biol Psychiatry"},{"key":"10.25259\/SNI_250_2026\/ref-28","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.janxdis.2008.10.009","article-title":"The epidemiology of anxiety disorders in the Arab world: A review","volume":"23","author":"Tanios","year":"2009","journal-title":"J Anxiety Disord"},{"key":"10.25259\/SNI_250_2026\/ref-29","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/occmed\/kqv054","article-title":"Hamilton rating scale for anxiety (HAM-A)","volume":"65","author":"Thompson","year":"2015","journal-title":"Occup Med (Lond)"},{"key":"10.25259\/SNI_250_2026\/ref-30","doi-asserted-by":"crossref","first-page":"17312","DOI":"10.1038\/srep17312","article-title":"Trait-related decision making impairment in obsessive-compulsive disorder: Evidence from decision making under ambiguity but not decision making under risk","volume":"5","author":"Zhang","year":"2015","journal-title":"Sci Rep"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/efficacy-management-of-adverse-effects-and-relapse-forms-after-obsessive-compulsive-disorder-surgery-the-first-egyptian-and-arab-cohort\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/efficacy-management-of-adverse-effects-and-relapse-forms-after-obsessive-compulsive-disorder-surgery-the-first-egyptian-and-arab-cohort\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T07:10:38Z","timestamp":1789110638000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/efficacy-management-of-adverse-effects-and-relapse-forms-after-obsessive-compulsive-disorder-surgery-the-first-egyptian-and-arab-cohort\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":30,"alternative-id":["10.25259\/SNI_250_2026"],"URL":"https:\/\/doi.org\/10.25259\/sni_250_2026","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"article-number":"517"}}