The effectiveness of psychosurgery in treating OCD
A CINGULOTOMY is a operation performed for anxiety disorders.
- BOER (95) looked at cingulotomy's and found they were effective in decreasing anxiety and OCD.
- DOUGHERTY found that up to 45 percent of patients were partially improved by this operation. However the sample was only 44 people so is very small.
- COSGROVE found that it only benefitted 30 percent of patients.
Overall this evidence is inconsistent. It has been suggested it is only effective for between 25 and 70 percent, depending on the criteria of success.
There are problems with some evidence of the effectiveness of psychosurgery;
CORAN (2007) suggest studies into psychosurgery are biased because they study the unblinded, which means the person administering the test knows the object of the study and why the patient has had the surgery. This could lead to the person exaggerating the cure or influencing the results with their knowledge.
Transcranial magnetic stimulation is another technique which avoids destruction of brain tissue. A large electromagnetic coil is place above the scalp near the forehead. This created painless electric currents that stimulate the frontal cortex, a region of the brain which is asscociated with OCD and mood regulation.
GREENBERG ET AL used TMS to treat 12 OCD patients. Two frontal sites were stimulated for 20 minutes resulting in a significant reduction in compulsive urges lasting atleast eight hours. However RODIGUEZ- MARTIN (03) found less impressive effects for TMS. They found when using TMS or sham TMS there was no measureable difference afterwards as assessed using Y-BOCS. This suggests that the earlier success might be due to a placebo effect.
The appropriateness of Psychosurgery
NYMEN ET AL conducted a follow up study of all OCD patients treated with a capsulotomy which is another psychosurgery procedure, in sweden between 78 and 90. Their IQ test performance, in general, remained intact. Some functioning had been adversely affected at the time of the operation, but recovery took place over time.
SZASZ (78) criticised psychosurgery, arguing that a state of mind is not physical and therefore it is illogical to suggest that surgery can be effective.