{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T08:55:03Z","timestamp":1784105703652,"version":"3.55.0"},"reference-count":59,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Functional neurosurgery has emerged as a potential therapeutic option for patients with severe, treatment-resistant psychiatric disorders such as obsessive\u2013compulsive disorder (OCD) and major depressive disorder (MDD). Among the most studied interventions, deep brain stimulation (DBS) has shown promising outcomes in open-label studies, though controlled trials have yielded more modest results. This discrepancy, along with concerns about surgical risks, neuropsychiatric side effects, and ethical challenges, has limited the broader implementation of psychiatric neurosurgery. This review explores the clinical complications of DBS\u2014including vascular events, infections, and hardware-related issues\u2014as well as cognitive and behavioral changes such as hypomania, apathy, and impulse control disorders. Ethical concerns are also addressed, including the difficulty of obtaining truly informed consent and the potential impact on personal identity. The article emphasizes the need for multidisciplinary teams, dynamic consent models, standardized protocols, and high-quality clinical trials to ensure safe, ethical, and effective use of neurosurgical interventions in psychiatry. Ultimately, the responsible integration of functional neurosurgery into psychiatric care requires not only technical precision but also ethical rigor and patient-centered collaboration.<\/jats:p>","DOI":"10.3390\/brainsci15121303","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T08:49:22Z","timestamp":1764665362000},"page":"1303","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Complications and Ethical Challenges in Neurosurgery for Psychiatric Disorders"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3420-0786","authenticated-orcid":false,"given":"Cristina V.","family":"Torres D\u00edaz","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitario de La Princesa, Universidad Aut\u00f3noma de Madrid, 28006 Madrid, Spain"},{"name":"Clinica Nuestra Se\u00f1ora Del Rosario, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn Luis Ayerbe","family":"Gracia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital\/Rey Juan Carlos, 41013 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Lara Almunia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital\/Rey Juan Carlos, 41013 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4671-2882","authenticated-orcid":false,"given":"Gonzalo Olivares","family":"Granados","sequence":"additional","affiliation":[{"name":"Clinical Neurosurgery Unit, Hospital Universitario Virgen De La Victoria, 29010 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta Navas","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitario de La Princesa, Universidad Aut\u00f3noma de Madrid, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma Pulido","family":"Rivas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitario de La Princesa, Universidad Aut\u00f3noma de Madrid, 28006 Madrid, Spain"},{"name":"Clinica Nuestra Se\u00f1ora Del Rosario, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta Del Alamo","family":"De Pedro","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, University Hospital Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0063-9301","authenticated-orcid":false,"given":"Rafael Garc\u00eda","family":"De Sola","sequence":"additional","affiliation":[{"name":"Clinica Nuestra Se\u00f1ora Del Rosario, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro","family":"Mole\u00f3n-Ruiz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Hospital Virgen del Roc\u00edo, Instituto Andaluz de Salud Cerebral, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"114869","DOI":"10.1016\/j.psychres.2022.114869","article-title":"Deep brain stimulation in obsessive-compulsive disorder: Results from meta-analysis","volume":"317","author":"Cruz","year":"2022","journal-title":"Psychiatry Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"E8","DOI":"10.3171\/2022.11.FOCUS22622","article-title":"Neurosurgery for psychiatric disorders: Reviewing the past and charting the future","volume":"54","author":"Bauerle","year":"2023","journal-title":"Neurosurg. 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