After Leucotomy

Review of Studies in Lobotomy. Edited by Milton Greenblatt, M.D., Robert Arnot, M.D., and Harry C. Solomon, M.D. (Pp. 495. 54 illustrations. £3 3s.) London: William Heinemann Medical Books, 1951, and of Personality and the Frontal Lobes. By Asenath Petrie. (Pp. 188. £1 Is.) London: Routledge and Kegan Paul. 1952.

British Medical Journal, 18 October 1952, p. 869 

   Both these works are attempts to find some rhyme and reason in the results that are produced by leucotomy, the first coming from the Boston Psychopathic Hospital, the second from the department of psychiatry at St. George's Hospital, London. In each case the-mode and the scale of  the work reflect the country of origin.

   No fewer than 30 collaborators took part in the American survey, which covers the after-history of 205 lobotomized patients, of whom the majority were schizophrenics. It was, however, the other diagnostic groups, the psychoneurotics, the involutionals, and the affective psychotics, who provided the best results. Almost every possible change was investigated: the cerebrospinal fluid, autonomic responses, E.E.G., psychology, sex behaviour, and sociology. In all these fields something has been learnt. The interesting but discouraging fact emerges, in this as in other studies, that there is extremely little correlation between the change in any easily measured function, such as the E.E.G. or a psychological

test, and clinical improvement.

   Mrs. Petrie's study is by herself alone. Twenty-seven patients, mostly suffering from obsessional neurosis or depressive disorders (a prognostically favourable group, of which only one was actually worse after operation), were tested before operation, and again three and nine months afterwards, by a very wide battery of psychological tests. These were of three different types-tests of "neuroticism," tests of introversion-extraversion, and tests of intellectual functions. On the whole the patients tended to become less "neurotic," less introverted, and less efficient at intellectual tests. Most of the individual sub-tests gave non-significant results; and it may well be that future workers along this line will feel that only those of Mrs. Petrie's tests which gave significant results will be worth trying out again. In this way she has probably provided a useful addition to our knowledge.