Psychosurgery : A history from Prefrontal Lobotomy to Deep Brain Stimulation

Abstract

Neurosurgical treatment for psychiatric disorders features a long and controversial history. This article explores a ‘spectrum of psychosurgery,’ describing how old-fashioned and controversial prefrontal lobotomy gradually evolved into modern day, mainstream scientific deep brain stimulation (DBS). We focus on the rise, fall and possible re-emergence of psychosurgery as a therapeutic intervention today.We journey through historic indiscriminate use of prefrontal lobotomy, which evoked stern criticism from both public and professionals, through to the development of modern day DBS - performed for patients suffering from severe, treatment resistant symptoms of obsessive-compulsive disorder (OCD), epilepsy and movement disorders.We hope this article will provide a basis for understanding the availability of existing treatment options and potential future opportunities, whilst simultaneously challenging any public/professional preconceptions of psychosurgery, which may indirectly be obstructing patient care.Additionally, we carried out a qualitative survey displayed in WordCloud Format, capturing the intellection of 38 mental health professionals working for North West Boroughs NHS Healthcare Foundation Trust, on ‘psychosurgery,’ ‘prefrontal lobotomy’ and ‘DBS’, which may well reflect wider public opinion.In summary, the article provides a brief, yet comprehensive overview of the controversial history of psychosurgery, present-day practice, and future trends of neurosurgery for psychiatric disorders.