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Modified Leucotomy Assessed by Forearm Blood Flow and Other Measurements

Published online by Cambridge University Press:  29 January 2018

D. H. W. Kelly ,
C. J. S. Walter  and
William Sargant
D. H. W. Kelly
Affiliation:
Department of Psychological Medicine, St. Thomas's Hospital, London, S.E.1
C. J. S. Walter
Affiliation:
Department of Psychological Medicine, St. Thomas's Hospital, London, S.E.1
William Sargant
Affiliation:
Department of Psychological Medicine, St. Thomas's Hospital, London, S.E.1
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Extract

The value of modified leucotomy in the treatment of psychiatric disorders is undergoing constant reappraisal. Ever since 1948 efforts have been made in the Department of Psychological Medicine of St. Thomas's Hospital and at Belmont Hospital to modify operative techniques and to learn more about the proper and discriminative selection of suitable patients within very varied diagnostic categories. A leading article in the British Medical Journal has called for renewed efforts along such lines. (Editorial, 1965). To enable various surgical procedures to be assessed and their merits and disadvantages compared more accurately, better objective methods of evaluating the effects of the operation are certainly required. Although several studies have been directed towards the measurement of intellectual function before and after operation (Mettler, 1949; Mettler and Landis, 1952; Tow, 1955) much less attention has been directed towards the objective assessment of personality changes and measurement of the reduction of key symptoms such as anxiety. Sykes and Tredgold (1964) emphasized what has been repeatedly stressed from this Department (Sargant, 1946, 1962; Sargant and Slater, 1944, 1948, 1954, 1963), that a decision to operate must take careful note of the individual symptoms, especially the degree of tension present. Falconer and Schurr (1959) consider that “the indication for operation should be, not the diagnostic label, but the tension and anxieties which the illness has produced”.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 112 , Issue 490 , September 1966 , pp. 871 - 881
Copyright
Copyright © Royal College of Psychiatrists, 1966 

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References

Abrahams, V. C. Hilton, S. M. and Zbrozyna, A. (1960). “Active muscle vasodilatation produced by stimulation of the brain stem: its significance in the defence reaction”. J. Physiol. (Lond.), 154, 491–513.Google Scholar
Barcroft, H. and Swan, H. J. C. (1953). Sympathetic Control of Human Blood Vessels. London.Google Scholar
Editorial. (1965). “Prefrontal leucotomy”. Brit. med. J., 1, 1083–1084.CrossRefGoogle Scholar
Eysenck, H. J. (1959). Manual of the Maudsley Personality Inventory,. London.Google Scholar
Falconer, M. A. and Schurr, P. H. (1959). “Surgical treatment of mental illness”. In Recent Progress in Psychiatry. (Ed. Fleming, G. W. T. H), Vol. 3, 352–367. London.Google Scholar
Freeman, W. (1953). “Prognosis in frontal lobotomy by use of the Malamud rating scale”. Amer. J. Psychiat., 109, 595–602.Google Scholar
Heath, R. G. and Mickle, W. A. (1960). “Evaluation of seven years' experience with depth electrode studies in human patients”. In Electrical Studies on the Un-anesthetized Brain. (Ed. Ramey, and O'Doherty, ). New York.Google Scholar
Jackson, H. (1954). “Leucotomy—a recent development”. J. ment. Sci., 100, 62–65.CrossRefGoogle Scholar
Kelly, D. H. W. (1965). “Measurement of anxiety by forearm blood flow”. M.D. Thesis. London University Library.Google Scholar
Kelly, D. H. W. (1966). “Measurement of anxiety by forearm blood flow”. Brit. J. Psychiat., 1966, 112, 789.CrossRefGoogle Scholar
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”. Brit. J. Surg., 51, 114–124.Google Scholar
Knight, G. C. and Tredgold, R. F. (1955). “Orbital leucotomy— a review of 52 cases”. Lancet, i, 981–985.CrossRefGoogle Scholar
Levinson, F. and Meyer, V. (1965). “Personality changes in relation to psychiatric status following orbital cortex undercutting”. Brit. J. Psychiat., 111, 207–218.Google Scholar
McKissock, W. (1959). “Discussion on psychosurgery”. Proc. Roy. Soc. Med., 52, 206–209.Google Scholar
Marks, I. M. Birley, J. L. T. and Gelder, M. G. (1966). “Modified leucotomy in severe agoraphobia: a controlled serial inquiry”. Brit. J. Psychiat., In press.Google Scholar
Mettler, F. A. (1949). Columbia-Greystone Associates— Selective Partial Ablation of the Frontal Cortex. New York.Google Scholar
Mettler, F. A. and Landis, C. (1952). Columbia-Greystone Associates 2nd Group. Psycho-surgical Problems. London.Google Scholar
Partridge, M. (1950). Prefrontal Leucotomy. Oxford.Google Scholar
Pippard, J. (1955). “Rostral leucotomy: a report on 240 cases personally followed up after 1½ to 5 years”. J. ment. Sci., 101, 756–773.CrossRefGoogle Scholar
Sainsbury, P. (1954). “The measurement and description of spontaneous movements before and after leucotomy”. J. ment. Sci., 100, 732–741.CrossRefGoogle Scholar
Sargant, W. (1946). Discussion: “Prefrontal leucotomy, with reference to indications and results”. Proc. Roy. Soc. Med., 39, 458.Google Scholar
Sargant, W. (1962). “The present indications for leucotomy”. Lancet, i, 1197–1200.CrossRefGoogle Scholar
Sargant, W. and Slater, E. T. O. (1944, 48, 54, 63). An Introduction to Physical Methods of Treatment in Psychiatry. Edinburgh.Google Scholar
Sargant, W. Walter, C. J. S. and Wright, N. (1966). “New treatment of some chronic tension states”. Brit. med. J., i, 322–324.CrossRefGoogle Scholar
Sykes, M. K. and Tredgold, R. F. (1964). “Restricted orbital undercutting: a study of its effects on 350 patients over the ten years 1951–60”. Brit, J, Psychiat., 110, 609–640.CrossRefGoogle Scholar
Taylor, J. A. (1953). “A personality scale of manifest anxiety”. J. abnorm. soc. Psychol., 48, 285–290.Google Scholar
Tow, F. M. (1955). Personality Changes Following Frontal Leucotomy. Oxford.Google Scholar
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