psychosurgery

what is the aim of psychosurgery?

to treat psychological disorders by removing or destroying problematic areas of the brain that causes symptoms

what is psychosurgery based on?

- the medical model: treating mental health like psychical health

when is psychosurgery used?

as a last resort, when no other methods work

name three different methods of psychosurgery

- prefrontal leucotomy

- transorbital lobotomy

- bilateral cingulotomy

what types of psychosurgery are traditional?

- prefrontal leucotomy

- transorbital lobotomy

what type of psychosurgery is modern?

bilateral cingulotomy

pre-frontal lobotomy

drilling two holes into the patients head and used a leucotome to destroy neural connections between the frontal lobe and the rest of the brain

transorbital lobotomy

- patient is rendered unconscious by electroshock

- going through the eyelids with an ice pick and piercing the thin bone that separates the eye sockets from the frontal lobes to sever connections in the brain

bilateral cingulotomy

an electrode or gamma knife is guided to the cingulate gyrus by means of magnetic resonance imaging. the surgeon will make a lesion to severe the circuit.

what does the pre-frontal leucotomy treat?

aggression and agitation commonly seen in schizophrenia

what is the transorbital lobotomy used to treat?

schizophrenia

depression

what is the bilateral cingulotomy used to treat?

chronic pain

treatment-resistant OCD

EFFECTIVENESS: strength, cosgrave

• Cosgrave and Raunch

• found that the bilateral cingulotomy

• is effective in 56% of OCD patients

• reduces symptoms, improves quality of life

EFFECTIVENESS: weakness, trad methods

• prefrontal leucotomy & transorbital lobotomy (6% fatality rate)

• severe side effects (swelling, headaches)

• bilateral lower fatality rate

• risk too high, worsen symptoms + side effects

EFFECTIVENESS: weakness, cant treat biological cause

• problematic brain areas removed

• ineffective against e.g. PTSD better treated CBT

• cognitive restructuring

ETHICS: strength, valid consent

• today cannot be performed w/o consent

• since 1983 under MH act, patient must give informed consent to undergo psychosrugery

• surgery is fully explained to the patient and must agree

• therefore, ethics regarding consent improved, compared to old methods

ETHICS: weakness, harm to patient

• severe side effects (swelling, headaches)

• psychosurgery is permanent and can’t be reversed

• therefore, patient may get worse after surgery than before