The Biological Therapy Flashcards
Psychosurgery
Name the biological therapy
Psychosurgery
Name the four forms of psychosurgery
Pre-frontal leucotomy, transorbital lobotomy, bilateral cingulotomy, deep brain stimulation
What technique is used in pre-frontal leucotomy?
Apple-corer process
Who created pre-frontal leucotomy and when was it made?
Moniz, 1930s
What object is inserted into the brain in pre-frontal leucotomy and what does it have on the end?
Leucotome, wire loop on the end
How does pre-frontal leucotomy work?
Two holes drilled into either side of the brain, leucotome rotated in frontal lobe to severe the nerve fibres and lesion the tissue
What technique is used in transorbital lobotomy?
Icepick technique
Who created transorbital lobotomy and when?
Freeman, 1940s
What object is used in transorbital lobotomy?
Orbitoclast
Where is the orbitoclast inserted and why?
Under the eyelid and into the back of the eye socket, it is the thinnest part of the skull
How does transorbital lobotomy work?
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
What is used to find a precise area of the brain in bilateral cingulotomy?
MRI scan
What are you under in bilateral cingulotomy?
General anaesthetic
How is brain tissue destroyed?
Radiation (gamma rays)
Why is deep brain stimulation different from other psychosurgery?
It’s temporary, not permanent
What does the biological approach assume that psychological disorders are caused by and what is this called?
Have a physiological / biological cause, referred to as the medical model of mental illness, treats mental disorders as if they were physical
Describe the effectiveness of early psychosurgery
Initial reports tended to be enthusiastic but undesirable side effects, e.g. unnatural tranquility, permanent side effects, Comer study
What did Comer find with early psychosurgeries?
Had a fatality rate of 6%, range of severe side effects like brain seizures, lack of emotional responsiveness, changes in personality
Describe the Rosemary Kennedy case
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
Describe the Cosgrove and Rauch study
56% of patients reported cingulotomy effective for OCD
Describe the Mary Lou Zimmerman case
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
Why is consent and ethical issue in psychosurgery?
Patients may not be in the right state of mind to give their informed consent
Why is harm an ethical issue in psychosurgery?
Early psychosurgeries - severe apathy and memory loss, modern side effects - seizures and altered mood, deep brain stimulation - seizures, changing to mood, worsening depression
