The Biological Therapy

Question 1

Name the biological therapy

Answer 1

Psychosurgery

Question 2

Name the four forms of psychosurgery

Answer 2

Pre-frontal leucotomy, transorbital lobotomy, bilateral cingulotomy, deep brain stimulation

Question 3

What technique is used in pre-frontal leucotomy?

Answer 3

Apple-corer process

Question 4

Who created pre-frontal leucotomy and when was it made?

Answer 4

Moniz, 1930s

Question 5

What object is inserted into the brain in pre-frontal leucotomy and what does it have on the end?

Answer 5

Leucotome, wire loop on the end

Question 6

How does pre-frontal leucotomy work?

Answer 6

Two holes drilled into either side of the brain, leucotome rotated in frontal lobe to severe the nerve fibres and lesion the tissue

Question 7

What technique is used in transorbital lobotomy?

Answer 7

Icepick technique

Question 8

Who created transorbital lobotomy and when?

Answer 8

Freeman, 1940s

Question 9

What object is used in transorbital lobotomy?

Answer 9

Orbitoclast

Question 10

Where is the orbitoclast inserted and why?

Answer 10

Under the eyelid and into the back of the eye socket, it is the thinnest part of the skull

Question 11

How does transorbital lobotomy work?

Answer 11

Orbitoclast inserted under eyelid and into back of eye socket, twisted to destroy connections with frontal lobe and other areas, repeated with other eye so same on both hemispheres

Question 12

What is used to find a precise area of the brain in bilateral cingulotomy?

Answer 12

MRI scan

Question 13

What are you under in bilateral cingulotomy?

Answer 13

General anaesthetic

Question 14

How is brain tissue destroyed?

Answer 14

Radiation (gamma rays)

Question 15

Why is deep brain stimulation different from other psychosurgery?

Answer 15

It’s temporary, not permanent

Question 16

What does the biological approach assume that psychological disorders are caused by and what is this called?

Answer 16

Have a physiological / biological cause, referred to as the medical model of mental illness, treats mental disorders as if they were physical

Question 17

Describe the effectiveness of early psychosurgery

Answer 17

Initial reports tended to be enthusiastic but undesirable side effects, e.g. unnatural tranquility, permanent side effects, Comer study

Question 18

What did Comer find with early psychosurgeries?

Answer 18

Had a fatality rate of 6%, range of severe side effects like brain seizures, lack of emotional responsiveness, changes in personality

Question 19

Describe the Rosemary Kennedy case

Answer 19

Not a successful procedure, mental capacity reduced to that of a two-year old, spent rest of her life institutionalised, could not walk or speak intelligibly

Question 20

Describe the Cosgrove and Rauch study

Answer 20

56% of patients reported cingulotomy effective for OCD

Question 21

Describe the Mary Lou Zimmerman case

Answer 21

OCD and depression, last resort, bilateral cingulotomy, major loss of normal functioning and abscess I’m her brain, developed dementia, be ame mute and emotionally disabled

Question 22

Why is consent and ethical issue in psychosurgery?

Answer 22

Patients may not be in the right state of mind to give their informed consent

Question 23

Why is harm an ethical issue in psychosurgery?

Answer 23

Early psychosurgeries - severe apathy and memory loss, modern side effects - seizures and altered mood, deep brain stimulation - seizures, changing to mood, worsening depression