Modified Leucotomy Assessed Clinically, Physiologically and Psychologically at Six Weeks and Eighteen Months

Abstract

After more than thirty years the operation of leucotomy still remains a controversial treatment, and its value is questioned by many. This scepticism, and the advent of new surgical techniques, have emphasized the need for careful appraisal of the results of psychosurgery. In a previous prospective study 40 patients were assessed six weeks after modified leucotomy, and 75 per cent of these patients were found to be clinically improved (Kelly, Walter and Sargant, 1966). They were less neurotic on the M.P.I., had lower Taylor Manifest Anxiety scores and rated themselves as less anxious; a good clinical outcome was associated with diminution of physiological arousal as measured by forearm blood flow and heart rate. This group has now been followed-up and reassessed 18 months after operation, and a further group of 38 patients has been examined before, and again six weeks after, leucotomy. The data from the two groups have been combined to determine the immediate outcome for various diagnostic categories, and a multiple regression has been performed to elicit which of the pre-operative factors predict a favourable post-operative result.