Citation

Bridges PK, Bartlett JR, Hale AS, Poynton AM, Malizia AL, Hodgkiss AD. Br. J. Psychiatry 1994; 165(5): 599-611; discussion 612-613.

Copyright

(Copyright © 1994, Royal College of Psychiatry)

DOI

10.1192/bjp.165.5.599

PMID

7866675

Abstract

BACKGROUND: Stereotactic subcaudate tractotomy (SST) is the only type of psychosurgery performed at the Geoffrey Knight Unit, London, where nearly 1300 operations have been done since 1961. Statistically reliable data are not available to prove the effectiveness of SST. A detailed statement about contemporary psychosurgery is given.
METHOD: Relevant publications from the Unit and via Medline are discussed. The outcome figures are reviewed. The outcome is assessed at the Unit in global and clinical terms, associated with results of self-completed questionnaires.
RESULTS: SST allows 40-60% of patients to live normal or near-normal lives, perhaps with continuation of medication. A reduction in suicide rate to 1% post-operatively, from 15% in cases of uncontrolled affective disorders is seen.
CONCLUSION: As a treatment of last resort, no controlled trial against a comparable treatment is possible. It appears reasonable to offer SST to patients with suicidal and deluded depression or with frequently swinging moods, not responding to other treatments.

Language: en

Keywords

Adult; Aged; Brain Mapping; Caudate Nucleus; Female; Humans; Male; Mental Disorders; Middle Aged; Peer Review; Psychosurgery; Stereotaxic Techniques; Treatment Outcome