Treatment of obsessive-compulsive disorder by psychosurgery
- 1 March 1993
- journal article
- research article
- Published by Wiley in Acta Psychiatrica Scandinavica
- Vol. 87 (3), 197-207
- https://doi.org/10.1111/j.1600-0447.1993.tb03356.x
Abstract
We report a longitudinal study of 26 patients with medically intractable obsessive-compulsive disorder (OCD) who were treated with psychosurgery and had a comprehensive follow-up for a mean 10 years. Seventeen patients had combined orbitomedial and cingulate lesions, 6 cingulate lesions only and 3 orbitomedial lesions only. Eighteen patients were interviewed personally and lesions verified on magnetic resonance imaging scans in fourteen. On a 6-point global rating scale, 10 (38%) patients had obvious improvement, another 6 (23%) showed mild improvement of doubtful clinical value, and the remaining 10 showed either no change (n= 6; 23%) or were judged to be worse (n= 4; 15%). Both obsessive and compulsive symptoms improved, and this change was independent of the changes in anxiety and depression scores. No significant predictors of improvement were identified. Patients with cingulate lesions only fared worse. Eight patients who had a second operation did not show much improvement. A comparison of a subgroup of patients with 10 matched nonsurgical OCD controls supported the contention that the improvement in OCD was attributable to the psychosurgery. Important adverse effects in the stereotactic surgery group (n= 20) were epilepsy (1 patient) and personality change (2 patients). The psychosurgery group performed relatively poorly on the Wisconsin Card Sort Test but did not show any deterioration in Wechsler Intelligence and Memory scores.Keywords
This publication has 37 references indexed in Scilit:
- Neurosurgical treatment of severe obsessive‐compulsive disorder associated with Tourette's syndromeMovement Disorders, 1990
- A Follow-Up of Adolescents with Obsessive-Compulsive DisorderThe British Journal of Psychiatry, 1989
- A cohort study of psychosurgery cases from a defined population.Journal of Neurology, Neurosurgery & Psychiatry, 1988
- Psychosurgery: waiting to make a comeback?Published by American Medical Association (AMA) ,1980
- Ethical considerations of psychosurgery: the unhappy legacy of the pre-frontal lobotomyJournal of Medical Ethics, 1980
- A Comparative Review of Patients with Obsessional Neurosis and with Depression Treated by PsychosurgeryThe British Journal of Psychiatry, 1973
- Stereotactic Limbic Leucotomy: Neurophysiological Aspects and Operative TechniqueThe British Journal of Psychiatry, 1973
- Stereotactic Limbic Leucotomy: A Preliminary Report on Forty PatientsThe British Journal of Psychiatry, 1973
- Bimedial Leucotomy in Obsessive-Compulsive Neurosis: A Controlled Serial EnquiryThe British Journal of Psychiatry, 1971
- A RATING SCALE FOR DEPRESSIONJournal of Neurology, Neurosurgery & Psychiatry, 1960