Simply put, psychosurgery is brain surgery performed to treat psychiatric disorders.
The term “psychosurgery” was coined by Portuguese neurologist, Antonio Egas Moniz.
This term is now often replaced by the term “neurosurgery for mental disorder.”
ilbusca / Getty Images
History of Psychosurgery
To date, the most well-known example of a psychosurgery is thelobotomy.
The lobotomy was developed by Antonio Egas Moniz in the mid-1930s.
He used it to “cure” a variety of mental health disorders, particularly depression and schizophrenia.
He believed that as new nerve connections formed, the patient’s “abnormal” behaviors would stop.
In 1949, Moniz received the Nobel Prize in physiology or medicine for his development of the prefrontal lobotomy.
In the late-1930s, neurologist Walter Freeman brought the surgery to the U.S.
Some patients were left severely brain damaged and hundreds died.
Even those procedures that were considered successful left patients unresponsive and childlike.
Despite the irreversible effects, psychosurgery was incredibly popular in the 1930s and 1940s.
An estimated 5,000 lobotomies were performed in 1949 in the U.S.
Furthermore, the techniques used today are radically different than those used in the past.
Rather, psychosurgery now involves destroying only tiny bits of tissue by heat.
Today, psychosurgery is much more carefully regulated than it was in the past.
For these people, anterior cingulotomy feels like a relatively effective treatment.
A heated probe then burns away about half a teaspoon of tissue in the anterior cingulate cortex.
Studies show that up to 70% of patients withtreatment-resistant OCDreceive some benefit from the procedure.
Anterior Capsulotomy
Another psychosurgery procedure used for treatment-resistant psychiatric disorders is called anterior capsulotomy.
Approximately 2% demonstrated postoperative seizures, and almost 7% demonstrated negative personality traits after surgery.
Limbic Leucotomy
Another important development for treatment-resistant psychiatric disorders is limbic leucotomy.
Limbic leucotomy has been used since the mid-1970s to treat MDD and of course, OCD.
This procedure is essentially a combination of anterior cingulotomy and subcaudate tractotomy.
It is usually done if a patient doesnt respond to anterior cingulotomy.
The side effects, which appear to be short term, include transient hallucinations, amnesia, and mania.
Recovery and Prognosis
For the vast majority of patients, response and/or recovery is a slow process.
Most patients spend at least two to three weeks in the hospital following psychosurgery.
Most people are able to tell if the treatment worked nine to 12 months after surgery.
Christmas D, Morrison C, Eljamel MS, Matthews K.Neurosurgery for mental disorder.Advances in Psychiatric Treatment.
2013;72(2):196-202; discussion 202. doi:10.1227/NEU.0b013e31827b9c7c
