54 Chapter 3 Figure 2. Time course of DBS-induced BMI (fixed effects ± SE). Linear mixed model analyses showed a significant linear effect of time on BMI (43.16±15.96, CI 95% 9.07-77.25, t=2.704, P=.017). Psychological: The primary psychological outcome YBC-EDS showed a significant improvement over time (-23.9%; P=.012). This effect was driven by significant decreases in both the Preoccupation and Rituals subscales (-16.2%; P=.026, and -31.1%; P=.001, respectively). This effect corresponded with the secondary outcome EDE-Q, which showed significant improvements over time on the subscales Restraint and Eating Concern (P=.039 and P=.024, respectively). The HAM-D and HAM-A showed additional significant improvements over time (-36.7% and -47.9%, respectively). The additional VAS questionnaire showed an increase in Impulsiveness (P<.001). Quality of Life: The primary outcome ED-QOL showed a significant improvement over time on the subscale Physical Health (P=.005). This effect was supported by secondary outcome MOS-SF-36, which showed a significant effect on the subscale Physical Function (P=.027). The SDS showed a significant effect on the subscale Responsibilities (P=.042). In the clinical interviews all four subjects stated that in their subjective experience, their overall quality of life had improved considerably. All four subjects indicated that they would choose DBS if they had to do it all over again, even though their eating disorder did not reach remission with DBS.
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