Are Surgeries done for psychiatry cases?

in StemSocial5 months ago



The answer to the question in the title is yes and to further impress you like I usually do…It is a field of health care defined by the World Health Organization. It includes all surgeries done to destroy neural pathways for behavioural conditions. They coined the field psychosurgies. It is basically surgery for psychiatric conditions.

Because some nerve connections have been named as causes of some conditions the thought is that if they are destroyed there will be a reduction in the symptoms. António Egas Moniz a portugeses neurologist was the first to use the term.

History of Psychosurgery

António Egas Moniz was the first to perform one of these surgeries in the 1930s they did these surgeries to treat depression and schizophrenia.

He did a lobotomy for these cases, particularly to the frontal lobe of the brain where he would disconnect neural tissue that was seen as the problem in these conditions.

Moniz went on to win the Nobel Prize for his work in developing prefrontal lobotomy.

Many died when Walter Freeman tried to perform these surgeries in America through the eye socket. If they didn’t die they ended up with brain damage.

The results of these surgeries were never really good it left patients unresponsive and they would behave like children. Even though this was going on, 5000 of these surgeries still took place in 1949 alone in the US.

The reason people continued to do it was that there were no other options. When antipsychotics became popular the numbers started to drop.

Use Today

These procedures reduced their number from common occurrences to the numbers today which are very low compared to the numbers before. It is only done when medical care and psychotherapy have failed.

Unlike before when the surgeon goes about destroying random parts of the brain he sees fit to destroy, now the destruction is very selective and does not affect the quality of life.

However, in very rare cases psychosurgery may be used to treat the following treatment-resistant conditions:

Today it is used to treat generalised anxiety disorder (GAD), major depression (MDD) and obsessive-compulsive disorder (OCD)r. The surgeries done are Anterior cingulotomy, Subcausdate tractotomoy and limbic leucotomy and anterior capsulotomy.

Because of what is known about these surgeries, it is only given as an option when other treatment options have failed.

Anterior Cingulotomy

While most patients with OCD eventually respond to treatment with medication and/or behavioural therapy, a small minority of people aren't so lucky. For these people, anterior cingulotomy appears to be a relatively effective treatment.

Many patients with OCD are responsive to medication but a small minority of these patients may require surgery. Anterior cingulotomy is the surgery done for these patients.

In this procedure, a teaspoon of tissue is burned in the anterior cingulate cortex.

The anterior cingulate cortex is the part of the brain that tells you when a job is complete and gives feeling a of relief.

In 70% of patients who need this surgery, there are good results. The risk of this surgery include seizures and infection but there are not very frequent.

Anterior Capsulotomy

Another psychosurgery procedure used for treatment-resistant psychiatric disorders is called an anterior capsulotomy. An anterior capsulotomy is similar to anterior cingulotomy, but instead of targeting the anterior cingulate cortex, surgeons burn away tiny bits of tissue in a region near the thalamus (called the anterior capsule).

This procedure is also done in psychiatry. The procedure is almost like anterior cingulotomy but in this procedure, the surgery is done on the thalamus. This procedure is effective in over 50% of those who suffer from OCD and are not responsive to treatment. The side effects are more common than in anterior cingulotomy. The risk of cerebral oedema, seizures urinary continent are common.

The procedure also has side effects of weight gain. This has been found in more than 20 studies. The weight gain was somewhere around 10% of the initial body weight.

Subcategory Tractotomy

In 1975 208 of these procedures were done and out of those who had the procedure done, 2 out of 3 of them had depression or anxiety and half of them with OCD showed good results. Even though it was shown to have good results, there are more side effects. The target tissue is usually white matter. The surgery is hardly done as a stand-alone procedure.

Limbic Leucotomy

This procedure was one of the latest procedures to be developed. It was started in the mid-1970s and was used for MMD and OCD. The procedure combines anterior cingulotomy and subcaudate tractotomy. It is done when a patient does not show good results with anterior cingulotomy. A study done in 2013 showed that over 70% of patients were responsive after not being responsive to anterior cingulotomy.

The side effects of the condition include short periods of hallucination, amnesia and mania.


The hospital stay after these procedures is somewhere between 2 to 3 weeks and it is usually a very slow process of recovery. Results are more pronounced after 9 or 12 months.



It is always scary when I hear of surgery that needs to be done on the brain, since you said there is a survival rate of 50%, I guess a lot of people will consider it an option when the case appears to get out of control.

Surgeries are scary...much less now than they use to be. The death rates were unimaginable

It is always scarcely whenever I hear the word surgery because I always believed it is 50% life and 50% death

Very true. But they are safer now than they use to be

Thanks for your contribution to the STEMsocial community. Feel free to join us on discord to get to know the rest of us!

Please consider delegating to the @stemsocial account (85% of the curation rewards are returned).

You may also include @stemsocial as a beneficiary of the rewards of this post to get a stronger support. 

Thank you!!