therapy

• Main components of psychosurgery


  • Prefrontal lobotomy
  • Leucotomy
  • Transorbital lobotomy
  • Bilateral cingulotomy
  • Deep brain stimulation (DBS)
• Prefrontal lobotomy

  1. Drilling holes in skull

  2. Inserting ice-pick like instrument

  3. Destroying nerve fibres
• Leucotomy


  1. Inserting narrow device (leucotome) into frontal lobe

  2. Extending and rotating retractable wire loop

  3. Destroying nerve fibres
• Transorbital lobotomy


  1. Inserting ice-pick knife under eyelid

  2. Breaking through skull

  3. Moving knife around to destroy nerve fibres- done through the eyes
• Bilateral cingulotomy

  1. MRI scans to locate exact points in brain

  2. Burning away nerve fibres with heated electrode tip

  3. Using gamma knife to beam radiation at specific location
• Deep brain stimulation (DBS)

  1. Threading wires through skull

  2. Embedding wires in brain

  3. Connecting to battery pack in chest

  4. Interrupting brain circuitry involved in disorder- such as OCD
• Modern psychosurgery


  • More precise
  • Less invasive
• Symptoms are treated rather than underlying cause of psychological disorder
• Prefrontal lobotomies had a fatality rate of up to 6% (comer)
• Prefrontal lobotomies caused physical harm and irreversible side effects- seizures and lack of responsiveness
• ETHICS: Prefrontal lobotomies were used to deal with 'difficult' mental patients
• Informed consent was not always given for prefrontal lobotomies especially those with severe psychological disorders
• The Mental Health Act (1983) states patient consent is now required for psychosurgery
• Effectiveness of psychosurgery

  • bilateral cingulotomy: 65% effective for major affective disorder
  • 56% effective for OCD
  • 70% effective for schizophrenia and anxiety
• 4 out of 6 patients with severe depression had symptoms dramatically reduced after deep brain stimulation
• Leucotomy


  A type of psychosurgery that involves making small cuts in the brain tissue of the frontal lobes; rarely used today due to risks and side effects
• Transorbital lobotomy


  A type of psychosurgery that involves inserting a thin instrument through the eye socket and into the brain to sever the connections between the frontal lobes and the rest of the brain; rarely used today due to significant risks and side effects
• Deep brain stimulation (DBS)


  A type of psychosurgery that involves implanting electrodes in specific areas of the brain and delivering electrical impulses to regulate abnormal brain activity; used to treat neurological and psychiatric conditions such as Parkinson's disease, dystonia, and OCD
• Prefrontal lobotomy


  A type of psychosurgery that involves severing the connections between the frontal lobes and the rest of the brain; rarely used today due to risks and side effects
• Bilateral cingulotomy


  A type of psychosurgery that involves making small cuts in the cingulate gyrus, a part of the brain that is involved in emotion and behavior; used to treat mental illnesses such as OCD and depression
• Ethics of psychosurgery


  Early techniques: no valid consent, usually treating severe depression so not in right Tate of mind to consent

  Can cause irreversible damage- changing cognitive abilities( memory loss) modern surgery still risks long term side effects