The neuroleptics, which were invented in the middle of the last century, have changed psychiatry as the clinical discipline, and a problem of the pharmacological resistance insensibly has become the main problem. A radical way to overcome the resistance of the anxious and depressive disorders lies in the field of the modern neurosurgical techniques. However, the verification of the resistance still requires more developed approach.

The main aim of our study was to develop and test an integrated neuropsychiatric approach in order to objectify the resistance and the disease severity for the selection of patients for surgical treatment.

We used different types of neuroimaging techniques for reviewing clinical and neurophysiological correlations: positron-emission tomography (PET), functional magnetic resonance imaging (fMRI), diffusion-tensor imaging (DTI) and its relations to the electroencephalography (EEG) data.

We examined 110 patients with depressive and anxious-obsessive disorders. 40 of them were examined using fMRI, 35 using PET and 35 using DTI. The patients were divided into groups by the ICD-10 criteria. The average age of the group was 46.3 years, the number of males and females in groups was approximately equal.

It was revealed that the degree of resistance had a significant correlation with the number of functional and structural neuroimaging indicators.

We obtained data which objectifies the concept of resistance. We also represent our understanding of clinical and physiological approach to the selection of target structures for stereotaxic neurosurgical exposure (in particular for deep brain stimulation) in the complex treatment.