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Modified Leucotomy Assessed Clinically, Physiologically and Psychologically at Six Weeks and Eighteen Months

Published online by Cambridge University Press:  29 January 2018

Desmond Kelly ,
C. J. S. Walter ,
Nita Mitchell-Heggs  and
William Sargant
Desmond Kelly
Affiliation:
St. George's Hospital Medical School, Atkinson Morley's Hospital, 31 Copse Hill, London, S. W.20
C. J. S. Walter
Affiliation:
Princess Alexandra Hospital, Harlow, Herts. and Essex General Hospital, Bishop's Stortford, and Severalls Hospital, Colchester
Nita Mitchell-Heggs
Affiliation:
St. George's Hospital Medical School, Atkinson Morleýs Hospital
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Extract

After more than thirty years the operation of leucotomy still remains a controversial treatment, and its value is questioned by many. This scepticism, and the advent of new surgical techniques, have emphasized the need for careful appraisal of the results of psychosurgery. In a previous prospective study 40 patients were assessed six weeks after modified leucotomy, and 75 per cent of these patients were found to be clinically improved (Kelly, Walter and Sargant, 1966). They were less neurotic on the M.P.I., had lower Taylor Manifest Anxiety scores and rated themselves as less anxious; a good clinical outcome was associated with diminution of physiological arousal as measured by forearm blood flow and heart rate. This group has now been followed-up and reassessed 18 months after operation, and a further group of 38 patients has been examined before, and again six weeks after, leucotomy. The data from the two groups have been combined to determine the immediate outcome for various diagnostic categories, and a multiple regression has been performed to elicit which of the pre-operative factors predict a favourable post-operative result.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 120 , Issue 554 , January 1972 , pp. 19 - 29
Copyright
Copyright © Royal College of Psychiatrists, 1972 

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References

Baker, E. F. W., Young, M. P., Gauld, D. M., and Fleming, J. F. R. (1970). ‘A new look at bimedial prefrontal leukotomy.’ Canadian Medical Association Journal, 102, 37–41.Google Scholar
Balasubramaniam, V. (1969). ‘Stereotactic amygdaloid lesions in behaviour disorder.’ Ph.D. Thesis. (Madras University.)Google Scholar
Ballantine, H. T., Cassidy, W. L., Flanagan, N. B., and Marino, R. (1967). ‘Stereotactic anterior cingulotomy for neuropsychiatric illness and intractable pain.’ Journal of Neurosurgery’, 26, 488–95.Google Scholar
Birley, J. L. T. (1964). ‘Modified frontal leucotomy: a review of 106 cases.’ British Journal of Psychiatry, 110, 211–21.CrossRefGoogle ScholarPubMed
Crow, H. J., and Phillips, D. G. (1970). ‘Multifocal frontal leucocoagulation in anxiety and obsessional illness.’ 2nd International Conference on Psychosurgery, Copenhagen.Google Scholar
Evans, P. (1971). ‘Failed leucotomy with misplaced cuts: a clinico-anatomical study of two cases.’ British Journal of Psychiatry, 118, 165–70.CrossRefGoogle ScholarPubMed
Eysenck, H. J. (1959). Manual of the Maudsley Personality Inventory, London.CrossRefGoogle Scholar
Falconer, M. A., and Schurr, P. H. (1959). ‘Surgical treatment of mental illness.’ In Recent Progress in Psychiatry. Vol. 3, (Ed. Fleming, and Walk, ), 352–67, London.Google Scholar
Hunter Brown, M., and Lighthill, J. A. (1968). ‘Selective anterior cingulotomy: a psychosurgical evaluation.’ Journal of Neurosurgery, 29, 513–19.Google Scholar
Jackson, H. (1954). ‘Leucotomy—a recent development.’ Journal of Mental Science, 100, 62–5.CrossRefGoogle Scholar
Kelly, D. H. W. (1967). ‘The technique of forearm plethysmography for assessing anxiety.’ Journal of Psychosomatic Research, 10, 373–82.CrossRefGoogle ScholarPubMed
Kelly, D. H. W., Walter, C. J. S., and Sargant, W. (1966). ‘Modified leucotomy assessed by forearm blood flow and other measurements.’ British Journal of Psychiatry, 112, 871–81.CrossRefGoogle ScholarPubMed
Knight, G. C. (1964). ‘The orbital cortex as an objective in the surgical treatment of mental illness—the results of 450 cases of open operation and the development of the stereotactic approach.’ British Journal of Surgery, 51, 114–24.Google ScholarPubMed
Knight, G. C. and Tredgold, R. F. (1955). ‘Orbital leucotomy—a review of 52 cases.’ Lancet, i, 981–5.Google Scholar
Laitinen, L., and Vilkki, J. (1970). ‘Ventral anterior cingulotomy in some psychological disorders.’ Second International Conference on Psychosurgery, Copenhagen.Google Scholar
McKissock, W. (1959). ‘Discussion on psychosurgery.’ Proceedings of the Royal Society of Medicine, 52, 206–9.Google ScholarPubMed
Marks, I. M., Birley, J. L. T., and Gelder, M. G. (1966). ‘Modified leucotomy in severe agoraphobia: a controlled serial inquiry.’ British Journal of Psychiatry, 112, 757–69.CrossRefGoogle ScholarPubMed
Pippard, J. (1955). ‘Rostral leucotomy: a report on 240 cases personally followed up after 1½ to 5 years.’ Journal of Mental Science, 101, 756–73.CrossRefGoogle ScholarPubMed
Post, F., Linford Rees, W., and Schurr, P. H. (1968). ‘An evaluation of bimedial leucotomy.’ British Journal of Psychiatry, 114, 1223–46.CrossRefGoogle ScholarPubMed
Roeder, F., and Muller, D. (1969). ‘The stereotactic treatment of paedophilic homosexuality.’ German Medical Monthly, 14, 265–71.Google Scholar
Sano, K. (1966). ‘Sedative stereoencephalotomy: fornicotomy, upper mesencephalic reticulotomy and postero-medial hypothalamotomy.’ In Progress in Brain Research, Ed. Tokizane, T. and Schadé, J. P., Elsevier Publishing Co., Amsterdam.Google Scholar
Ström-Olsen, R. (1970). Personal Communication.Google Scholar
Ström-Olsen, R. and Carlisle, S. (1971). ‘Bi-frontal stereotactic tractotomy. A follow-up study.’ British Journal of Psychiatry, 118, 141–54.CrossRefGoogle ScholarPubMed
Taylor, J. A. (1953). ‘A personality scale of manifest anxiety.’ Journal of Abnormal and Social Psychology, 48, 285–90CrossRefGoogle ScholarPubMed
Turner, E. A. (1970). ‘Operations for aggression. Bilateral temporal lobotomy and posterior cingulectomy.’ Second International Conference on Psychosurgery, Copenhagen.Google Scholar
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