Deep Brain Stimulation for Treatment-Refractory Major Depression

Inclusion Criteria

• •Major depression (MD), severe, unipolar type
• •German mother tongue
• •Hamilton Depression Rating Scale (HDRS24) score of \> 20
• •Global Assessment of Function (GAF) score of \< 45
• •At least 4 episodes of MD or chronic episode \> 2 years
• •\> 5 years after first episode of MD
• •Failure to respond to \*adequate trials (\>5 weeks at the maximum recommended or tolerated dose) of primary antidepressants from at least 3 different classes;
• •* adequate trials (\>3 weeks at the usually recommended or maximum tolerated dose) of augmentation/combination of a primary antidepressant using at least 2 different augmenting/combination agents (lithium, T3, stimulants, neuroleptics, anticonvulsants, buspirone, or a second primary antidepressant); \*an adequate trial of electroconvulsive therapy \[ECT\] (\>6 bilateral treatments) and; \*an adequate trial of individual psychotherapy (\>20 sessions with an experienced psychotherapist).
• •Able to give written informed consent
• •No medical comorbidity
• •Drug free or on stable drug regimen at least 6 weeks before study entry