Is psychosurgery antimanic?
| Autor: | Preminder Sachdev, John Matheson, John Sydney Smith |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Psychoanalysis Bipolar Disorder business.operation Postoperative Complications medicine Humans In patient Manic State Postoperative delirium Psychiatry Biological Psychiatry Aged Psychiatric Status Rating Scales Depressive Disorder Bipolar illness Middle Aged Frontal Lobe Psychosurgery Endogenous depression Female medicine.symptom business Psychology Mania Transorbital Follow-Up Studies |
| Zdroj: | Biological psychiatry. 27(3) |
| ISSN: | 0006-3223 |
| Popis: | Chronic or persistently recurrent endogenous depression with a limited or absent response to a prolonged trial of routine therapies is considered the prime indicar;~n for psychosurgery in contemporary literature (Bartlett et al. 1981; Kiloh et al. 1988). The position with regard to bipolar affective disorder is unclear. Reports of psychosurgery on patients currently manic or with a history of mania are few and the results are conflicting. The studies published in the 1940s and 50s often did not differentiate unir~olar from bipolar illness. Those that did (Jones and Shanklin 1950; Stengel 1950; Partridge 1950; Tow and Lewin 1953; Pippard 1955) involved only a few subjects. Two of O~ese studies (Jon~s and Shanklin 1950; Tow and Lewin 1953) reported recovery or improvement in 8 of 9 patients, using transorbital (Jones and Shanldin 1950) and orbital (Tow and Lewin 1953) leucotomy. Stengel (1950) reported an attenuation of manic attacks after psychosurgery. The other two studies (Partridge 1950; Pippard 1955) using rostral and prefrontal leucotomy, were relatively unfavorable. Of the 16 cases of manic-depressive illness reported by Partridge (1955), only 3 showed sustained improvement; in 1 of these the episodes had always been very mild. He concluded in his influential monograph that the operation was most effective in patients without a history of manic attacks. He also reported the occurrence of mania for the first time after psychosurgery. Pippard (1955) documented 10 patients who developed mania for the first time after leucotomy. These two studies probably explain the lack of attention to mania in subsequent reports on psychosurgery. The studies that were reported in the 1960s and 70s (Hirose 1965; Hetherington et al. 1972; Bailey et al. 1973) also suffered form the drawback of few numbers, poor case definition, and inadequate description of outcome, and did not add significantly to the argument. Hirose (1965) indicated that 2 of his 4 patients with "circular psychoses" did well. Hetherington et al. (1972) operated on manic patients but unfortunately did not differentiate them in their results. Bailey et al. (1973) published the largest series of patients with "cycloid illnesses" and indicated that 23 of 29 did well, the report being short on detail. Lopez and Lopez-lbor (1977) reported, without providing detailed descriptions, that in their patients a transient postoperative delirium ("psycho-organic syndrome") was an almost invariable accompaniment of open leucotomy and this was often combined with a manic state. In fact, they correlated this with good long-term results. |
| Databáze: | OpenAIRE |
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