Psychiatric consultation outcomes in deep brain stimulation candidacy: clinical and psychosocial correlates from a retrospective cohort.

BACKGROUND/

OBJECTIVES

Preoperative psychiatric assessment in deep brain stimulation (DBS) candidacy extends beyond contraindication screening to include informed consent capacity and psychosocial preparedness. This study examined factors associated with psychiatric consultation outcomes in DBS candidates.

METHODS

This retrospective single-centre study reviewed 363 patients referred for preoperative psychiatric consultation at Etlik City Hospital between September 2022 and January 2026. Outcomes were classified as "suitable," "conditionally suitable," or "not suitable." Associations were assessed using univariate analyses, with multinomial logistic regression including NMS restricted to the Parkinson's disease subgroup.

RESULTS

Outcomes were "suitable," "conditionally suitable," and "not suitable" in 66.9%, 22.6%, and 10.5% of patients, respectively. Among patients with Parkinson's disease, psychiatric history was present in 35.3% and NMS in 73.5%. In the adjusted subgroup model, limited/absent support, insufficient informed-consent capacity, and NMS were correlates of "conditionally suitable" status, whereas limited/absent support, insufficient consent capacity, impaired cognitive status, and psychiatric history were correlates of "not suitable" status (psychiatric history: aOR = 5.513, 95% CI 1.941-15.657, p = 0.001). As these variables contributed to outcome classification, they should be interpreted as correlates rather than independent predictors. Age, sex, education, and SMMSE score were not significantly associated with outcome.

CONCLUSIONS

Within the Parkinson's disease subgroup, social/care support, informed-consent capacity, psychiatric history, and NMS were associated with consultation outcome, whereas demographic factors and SMMSE score were not. Cognitive status showed only a category-specific association with the "not suitable" outcome and should be interpreted cautiously. These findings support structured psychiatric assessment in multidisciplinary DBS candidate selection.