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Resistant Bipolar Affective Disorder Treated by Stereotactic Subcaudate Tractotomy

Published online by Cambridge University Press:  02 January 2018

A. Poynton
Affiliation:
United Medical and Dental Schools, Guy's Hospital and the Geoffrey Knight Unit for Affective Disorders
P. K. Bridges*
Affiliation:
United Medical and Dental Schools, Guy's Hospital and the Geoffrey Knight Unit for Affective Disorders
J. R. Bartlett
Affiliation:
Regional Neurosurgical Centre and the Geoffrey Knight Unit for Affective Disorders, Brook General Hospital
*
United Medical and Dental Schools, Guy's Hospital SEI 9RT and the Geoffrey Knight Unit for Affective Disorders, Brook General Hospital, London SEI8 4LW

Abstract

The results of stereotactic subcaudate tractotomy in nine patients with resistant bipolar affective disorder are presented in the form of a single case study with a summary of the other eight cases. Follow-up studies at 2–4 years showed substantial improvement in five patients and amelioration of symptoms in a further four patients, with a tendency for a greater improvement in the manic than in the depressive episodes. These preliminary results suggest that there is a place for this operation in the management of severe bipolar affective disorders which are not responding to any other treatment, although decisive recovery occurs less often than with unipolar depression.

Type
Annotation
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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References

Bailey, H. R., Dawling, J. L. & Davies, E. (1977) Studies in depression IV. Cingulotractotomy and related procedures for severe depressive illness. In Neurosurgical Treatment in Psychiatry, Pain and Epilepsy (eds Sweet, W. H., Obrador, S. & Martin-Rodriguez, J. G.). Baltimore, MD: University Park Press.Google Scholar
Board of Control (England and Wales) (1947) Prefrontal leucotomy in 1,000 cases. London: HMSO.Google Scholar
Bridges, P. K. (1972) Psychosurgery today: psychiatric aspects. Proceedings of the Royal Society of Medicine, 65, 11041108.Google Scholar
Bridges, P. K. (1973) Methods of assessing patients for psychosurgery and outcome after operation. Psychiatrica, Neurologia et Neurochirurgia, 76, 335344.Google Scholar
Bridges, P. K., Bartlett, J. R. & Kelly, D. (1981) Contemporary indications for psychosurgery. British Journal of Psychiatry, 38, 507511.Google Scholar
Corsellis, J. A. N. & Jack, A. B. (1973) Neuropathology observations on yttrium implants and on undercutting in the orbito-frontal areas of the brain. In Surgical Approaches in Psychiatry (eds Laitinen, L. & Livingston, K. E.). Lancaster: Medical and Technical Publishing.Google Scholar
Goktepe, E. O., Young, L. & Bridges, P. K. (1975) A further review of the results of stereotactic subcaudate tractotomy. British Journal of Psychiatry, 126, 270280.Google Scholar
Jones, C. H. & Shanklin, J. G. (1950) Transorbital lobotomy in institutional practice. American Journal of Psychiatry, 107, 120127.Google Scholar
Knight, G. C. & Tredgold, R. F. (1955) Orbital leucotomy – a review of 52 cases. The Lancet, i, 981986.Google Scholar
Knight, G. D. (1965) Stereotactic tractotomy in the surgical treatment of mental illness. Journal of Neurology, Neurosurgery and Psychiatry, 28, 304310.Google Scholar
Leonhard, K., Kroff, I. & Schulz, H. (1959) Die Temperamente in den Familien der monopolaren und bipolaren phasischen Psychosen. Psychiatry and Neurology, 143, 416434.Google Scholar
Lovett, L. M. & Shaw, D. (1987) Outcome in bipolar affective disorder after stereotactic tractotomy. British Journal of Psychiatry, 151, 113116.Google Scholar
Newcombe, R. (1975) The lesion in stereotactic subcaudate tractotomy. British Journal of Psychiatry, 126, 478481.Google Scholar
Partridge, M. (1950) Prefrontal leucotomy. A survey of 300 cases personally followed over 1.5–3 years. Oxford: Blackwell.Google Scholar
Pippard, J. (1955) Rostral leucotomy: a report of 240 cases personally followed up after 1.5–5 years. Journal of Mental Science, 101, 774787.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research Diagnostic Criteria (RDC)for a Selected Group of Functional Disorders (3rd edn). New York: New York State Psychiatric Institute.Google Scholar
Tooth, G. C. & Newton, M. P. (1961) Leucotomy in England and Wales 1941–1954. Ministry of Health Reports on Public Health and Medical Subjects, No. 104. London: HMSO.Google Scholar
Tow, P. M. & Lewin, W. (1953) Orbital leucotomy. The Lancet, ii, 644649.Google Scholar
Wilson, W. W., Pittman, A. R., Bennett, R. E. & Garber, R. S. (1953) Results of transorbital lobotomy in 400 State hospital patients. Neurology, 3, 879885.Google Scholar
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