A Comparative Review of Patients with Obsessional Neurosis and with Depression Treated by Psychosurgery

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Abstract
Obsessional neurosis can be more resistant to treatment, and sometimes even to amelioration, than almost any other form of psychiatric illness. Pollitt (1969) has pointed out that, ‘true obsessional states are among the few illnesses that can still torture patients almost for a lifetime’, and other reports have shown that a generally bad prognosis is to be expected among such patients (Kringlen, 1965; Templer, 1972). As a means of helping patients with obsessional illnesses, various types of psychosurgical operation have been attempted (Lewin, 1961; Knight, 1964; Post, Rees and Schurr, 1968; Knight, 1969). In this paper we present a detailed review of a series of patients who had undergone stereotactic psychosurgical operations for these conditions, in order to assess the value of this method of treatment and also to attempt to identify factors which might have prognostic significance. Some of the patients reviewed had also had second operations of other types.