Frontal leukotomy and related psychosurgical procedures in the era before antipsychotics (1935-1954): a historical overview
- PMID: 7900928
- DOI: 10.1176/ajp.152.4.505
Frontal leukotomy and related psychosurgical procedures in the era before antipsychotics (1935-1954): a historical overview
Abstract
Objective: This article provides an overview of the history of psychosurgery as a treatment for psychiatric illnesses.
Method: The author reviewed articles describing psychosurgery between 1935 and 1954 in order to summarize surgical techniques, clinical indications for surgery, patient selection, complications, and outcome.
Results: Patients were operated on for a wide variety of psychiatric illnesses. Initially, a large number of uncontrolled studies reported considerable therapeutic benefit in at least one-third of the patients operated on. Complications with the early surgical techniques included hemorrhage, seizures, infection, and personality changes. Surgical techniques proliferated in hopes of achieving greater therapeutic benefit while minimizing detrimental side effects. As psychosurgery became more widely accepted, its principal supporters began to use it as a routine therapy. A number of uncontrolled and controlled short-term studies supported the efficacy of psychosurgery, but long-term controlled studies showed mixed results.
Conclusions: Psychosurgery was promoted as a treatment for patients who had shown little or no response to less drastic therapies. In the context of an era when no efficacious treatments were available for psychosis, its use was understandable. However, its history illustrates the importance of critical evaluation of new treatments in the context of long-term controlled outcome studies, the natural course of specific illnesses, and an understanding of brain physiology.
Similar articles
-
Psychosurgery: past, present, and future.Brain Res Brain Res Rev. 2005 Jun;48(3):409-19. doi: 10.1016/j.brainresrev.2004.09.002. Brain Res Brain Res Rev. 2005. PMID: 15914249
-
Psychosurgery in the modern era: therapeutic and ethical aspects.Med Law. 1992;11(5-6):449-53. Med Law. 1992. PMID: 1484467
-
Topectomy versus leukotomy: J. Lawrence Pool's contribution to psychosurgery.Neurosurg Focus. 2017 Sep;43(3):E7. doi: 10.3171/2017.6.FOCUS17259. Neurosurg Focus. 2017. PMID: 28859560
-
[Psychosurgical treatment of malignant OCD: three case-reports].Encephale. 2003 Nov-Dec;29(6):545-52. Encephale. 2003. PMID: 15029089 Review. French.
-
Contemporary psychosurgery and a look to the future.J Neurosurg. 2001 Dec;95(6):944-56. doi: 10.3171/jns.2001.95.6.0944. J Neurosurg. 2001. PMID: 11765838 Review.
Cited by
-
Mental health outcomes before psychotropic medications: a retrospective case series of one state hospital records from 1945 to 1954.BMC Health Serv Res. 2023 Mar 15;23(1):257. doi: 10.1186/s12913-023-09235-8. BMC Health Serv Res. 2023. PMID: 36922840 Free PMC article.
-
Controversies in Selecting Nobel Laureates: An Historical Commentary.Rambam Maimonides Med J. 2022 Jul 31;13(3):e0022. doi: 10.5041/RMMJ.10479. Rambam Maimonides Med J. 2022. PMID: 35921488 Free PMC article.
-
Deep Brain Stimulation for Intractable Obsessive-Compulsive Disorder and Treatment-Resistant Depression.Focus (Am Psychiatr Publ). 2022 Jan;20(1):55-63. doi: 10.1176/appi.focus.20210029. Epub 2022 Jan 25. Focus (Am Psychiatr Publ). 2022. PMID: 35746939 Free PMC article.
-
Psychosurgery in the History of Stereotactic Functional Neurosurgery.Stereotact Funct Neurosurg. 2020;98(4):241-247. doi: 10.1159/000508167. Epub 2020 Jun 29. Stereotact Funct Neurosurg. 2020. PMID: 32599586 Free PMC article.
-
Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Long Term Naturalistic Follow Up Study in a Single Institution.Front Psychiatry. 2020 Feb 28;11:55. doi: 10.3389/fpsyt.2020.00055. eCollection 2020. Front Psychiatry. 2020. PMID: 32184741 Free PMC article.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Research Materials