PSYCHOSURGERY Flashcards
(18 cards)
WHAT IS PSYCHOSURGERY?
Psychosurgery is a surgical procedure for treating mental disorders. The surgery involves removing or destroying parts of the brain.
WHAT DOES PSYCHOSURGERY TREAT?
Psychosurgery treats mental disorders, such as OCD, Depression, Bipolar, and in some cases schizophrenia (lesser extent).
HOW DOES THE BIOLOGICAL ASSUMPTION LINK TO PSYCHOSURGERY?
Psychosurgery is based on the biological approach assumption that suggests Localisation of specific brain structures and chemicals in the brain can be associated with specific behaviour and changes in behaviour.
HISTORIC FORMS OF PSYCHOSURGERY?
- Prefrontal Leucotomy
- Transorbital Lobotomy
MODERN FORMS OF PSYCHOSURGERY?
- Stereotactic psychosurgery
- Deep Brain Stimulation (DBS)
PREFRONTAL LEUCOTOMY IS…
- Historic psychosurgery
- Holes are drilled into the side or top of the skull
- Sharp object is used (ice pick resemblance), later on leucotome, and inserted in.
- Object is moved side to side
- Destroys nerve fibres and cuts connections from the frontal lobe.
THEREFORE PREFRONTAL LEUCOTOMY…
Therefore, prefrontal leucotomy involves selective destruction of nerve fibres of the frontal lobe in order to treat problematic behaviour.
WHO DEVELOPED PREFRONTAL LEUCOTOMY?
Developed by Egaz Moniz in 1935
STEREOTACTIC PSYCHOSURGERY IS…
- Modern form of psychosurgery
- Used as the last resort
- More precise
- Treats: OCD, Bipolar, Depression, Eating Disorders
- Done using anaesthetic
- Uses MRI scans to locate exact points in the brain
- Severs connections very precisely.
STEREOTACTIC PSYCHOSURGERY IN OCD
- There is a circuit linking the orbital frontal lobe to deeper structures in the brain. i.e Thalamus
- It appears to be more active than normal.
- Bilateral cingulotomy is designed to interrupt this circuit
- Done by burning away tissue using a heated electrode
- OR non-invasive tool; Gamma Knife (focused beams of radiation)
THEREFORE STEREOTACTIC PSYCHOSURGERY…
Therefore stereotactic psychosurgery is a more precise and modern form of psychosurgery, using MRI and computer machines to be precise.
Uses electrodes OR a Gamma knife.
DEEP BRAIN STIMULATION (DBS) IS…
- Alternative to Psychosurgery
- Modern form of psychosurgery
- Wires are thread through the skull and are embedded in brain
- No tissue destruction
- Only temporary
- Wires are connected to battery pack on patients chest
- Batteries produce high frequency currents
- It interrupts the circuitry involved in the disorder
- CAN BE TURNED OFF
EARLY PSYCHOSURGERY
(EVALUATING)
- Inappropriate and mostly ineffective
- Had a fatality rate of 6%
- Physical side effects (seizures, lacking emotional responsiveness)
MODERN PSYCHOSURGERY
(EVALUATING)
- Could have same issues as earlier psychosurgery (Comer 2002)
- Cingulotomy was 56% effective in OCD patients, 67% in capsulatonomy (Cosgrove 2001)
- BUT sample sizes were small
- 4/6 patients had striking performances with DBS (Mayberg 2005)
APPROPRIATENESS OF PSYCHOSURGERY
(EVALUATING)
- Limited in uses
- Rarely used to treat phobias
- Not used to treat schizophrenia
FUUTURE DIRECTIONS
(EVALUATING
- Technology ad science have made psychosurgery more effective
- Able to provide information that other scans cannot
VALID CONSENT
(ETHICS)
Early uses
- Mental asylums on patients who had not necessarily given consent
- Vulnerable
Modern
- Argue that there are vulnerable patients and may not be in right state of mind to give consent
- 1983 Mental Health Act informed consent is needed to undergo psychosurgery
- If more ethical treatment can be used, psychosurgery is prevented
- LAST RESORT and must get consent whether from family or themselves.
IRRIVERSIBLE DAMAGE
(ETHICS)
- Effects cannot be reversed
- Early psychosurgery resulted in significant changes to Patients cognitive abilities (memory loss) and blunted emotions
- Side effects could get worser than prior to surgery
- Modern psychosurgery has reduced risks due to precise targetting but may still have long term risks
