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Lobotomy, also known asleucotomy, is a type ofbrainsurgery. It was created in 1935 byAntónio Egas Moniz, aPortugueseneurologist. He won theNobel Prize in Physiology or Medicine in 1949 "for his discovery of the therapeutic value of leucotomy in certain psychoses".[1] The operation cut the connections from thepre-frontal cortex (front part of thefrontal lobes) to the rest of the brain. At first it seemed a great success, but the operation is now rarely done.
He used the method for certain types ofmental illness for which there was no othertreatment. He first used it on patients withobsessive behaviour, which they repeated time and again. It was also used to treat other mental illnesses, such asschizophrenia andclinical depression.
The problem with lobotomies was that they forever changed a person'spersonality andbehaviour. Sometimes, the results were beneficial: patients which had beenviolent became calm. But long-term studies, which were not done by Moniz, show some had severely damaged personalities. They often had very little 'drive' andmotivation.
Today,antipsychoticdrugs, likechlorpromazine, may treat thesymptoms of such disorders. Lobotomies are not common today.
One question is why was such a dramatic surgical technique so widely accepted. It is generally agreed thatpsychiatrists wanted to find some way of helping thousands of patients inpsychiatric hospitals in thetwentieth century.[2] Also, those same patients had little power to resist the increasingly radical and even reckless interventions ofasylum doctors.[3]
According to thePsychiatric Dictionary in 1970:
Good results are obtained in about 40 percent of cases, fair results in some 35 percent and poor results in 25 percent. Themortality rate probably does not exceed 3 percent. Greatest improvement is seen in patients whosepremorbid personalities were 'normal',cyclothymic, orobsessive compulsive; in patients with superiorintelligence and good education; inpsychoses with suddenonset and a clinical picture ofaffective symptoms of depression oranxiety, and with behaviouristic changes such as refusal of food, overactivity, anddelusional ideas of aparanoid nature.[4]
According to the same source, prefrontal lobotomy reduces:
anxiety feelings andintrospective activities; and feelings ofinadequacy and self-consciousness are thereby lessened. Lobotomy reduces the emotional tension associated withhallucinations and does away with thecatatonic state. Because nearly all psychosurgical procedures have undesirableside effects, they are ordinarily resorted to only after all other methods have failed. The less disorganized the personality of the patient, the more obvious are post-operative side effects. ...[4]
Convulsiveseizures are reported as [effects] of prefrontal lobotomy in 5 to 10 percent of all cases. Such seizures are ordinarily well controlled with the usual anti-convulsive drugs. Post-operative blunting of the personality,apathy, andirresponsibility are the rule rather than the exception. Other side effects includedistractibility, childishness,facetiousness, lack oftact ordiscipline, and post-operativeincontinence.[4]
