Therapy: Psychosurgery

Front 1

How do the assumption apply to psychosurgery?

Back 1

1. The biological approach assumes that psychological disorder, such as depression and anxiety have a physiological cause. This, therefore, would lead the use of the medical model, which suggests the patient should be treated through directly manipulating bodily processes.

2. Through the second assumption, localisation of brain function (the idea that certain areas of the brain have different functions), destroying or removing the damaged part may improve psychological problems.

3. The third assumption - neurotransmitters, can be addressed via modern methods of brain stimulation.

Front 2

What is a transorbital lobotomy?

Back 2

1. A transorbital lobotomy is the insertion of a sharp instrument through the eye socket damaging the prefrontal cortex.

2. A transorbital lobotomy was most commonly used during the 1940s and 1950s to reduce aggressive behaviour.

Front 3

What is a prefrontal lobotomy?

Back 3

1. A prefrontal lobotomy is the procedure involving the selective destruction of nerve fibres in the frontal lobe.

2. The frontal lobe controls impulse control and mood regulation, therefore treating affective disorders (such as depression, OCD, and less successfully schizophrenia).

Front 4

What is a prefrontal leucotomy?

Back 4

1. It was developed by the Portuguese neurologist Egas Moniz in the 1930s.

2. A prefrontal leucotomy is based on drilling holes on either side of the skull and inserting a leucotome (an instrument with a retractable wire) and cutting into the white matter - damaging the nerves.

Front 5

What is stereotactic psychosurgery?

Back 5

1. Stereotactic psychosurgery is a far more precise surgery, it is typically used for: OCD, bipolar disorder, depression and eating disorders.

2. An MRI scan to locate the effected area, and severe connections precisely.

Front 6

What is a bilateral cingulotomy?

Back 6

1. The severing of the connections between the orbital frontal lobe and deeper structures such as the thalamus.

2. An electrode can be used to burn away tissue, or alternatively a non-invasive gamma knife - a beam of radiation, can be used.

Front 7

What is a capsulotomy?

Back 7

1. Probes are inserted into the capsule, an area near the hypothalamus, and are heated to burn away tissue.

Front 8

Whats is deep brain stimulation?

Back 8

1. Deep brain stimulation is the threading of wires into the affected area, which is contacted to a battery pack and has an adjustable frequencies, which can disrupt circuits.

2. Deep brain stimulation includes no tissue destruction and is only temporary.

Front 9

How effective was early psychosurgery?

Back 9

1. Early practice of psychosurgery was ineffective and inappropriate.

2. Early lobotomies had a 6% fatality rate.

3. Comer (2002) observed the side effects such as brain seizures and lack of emotional response.

Front 10

How effective is modern psychosurgery?

Back 10

1. Cosgrove and Rauch (2001) reported that a bilateral cingulotomy was effective in 56% of OCD patients and a capsulotomy was effective in 65% of patients with major affective disorders.

2. Cosgrove and Rauch (2001) also suggested that the sample size wasn't big enough (25 patients per annum).

3. Bridges et al. (1994) pointed out that there is no comparable treatment.

4. Mayberg et al. (2005) found that four of 6 patients with depression reacted positively to DBS.

Front 11

Is psychosurgery appropriate?

Back 11

1. Psychosurgery can rarely be used to treat phobias and never schizophrenia.

2. Szasz (1978) criticised psychosurgery as a person's psychological self is not the same a physiological and therefore should not be treated in the same way.

Front 12

What is the future of psychosurgery?

Back 12

1. EEG (electroencephalograph) - can show when the activity is happening.

2. fMRI (functional magnetic resonance imaging) - can show where the activity is happening.

Front 13

What are the ethical issues of psychosurgery?

Back 13

1. Patients with severe depression may not always be capable of submitting a fully valid consent form, as the may not qualify the British Mental Health Act (1983).

2. Psychosurgery is irreversible and may cause deficits in the patients cognitive capabilities such as memory loss.