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The British Journal of Psychiatry (1966) 112: 757-769. doi: 10.1192/bjp.112.489.757
© 1966 The Royal College of Psychiatrists
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Modified Leucotomy in Severe Agoraphobia: A Controlled Serial Inquiry

I. M. MARKS M.D., D.P.M.1, J. L. T. BIRLEY B.A., M.R.C.P., D.P.M.2, and M. G. GELDER M.A., D.M., M.R.C.P., D.P.M.3

1 Research Worker and Senior Registrar
2 Member of Scientific Staff, M.R.C. Social Psychiatry Unit, and Senior Registrar
3 Senior Lecturer, Institute of Psychiatry and The Maudsley Hospital, London, S.E.5

1. Twenty-two patients who had had a modified leucotomy for anxiety and severe agoraphobia were compared with matched controls over a period of five years after treatment.

2. Leucotomy patients did significantly better than controls with respect to phobias and general anxiety; depression remained mild; work adjustment improved markedly. Personality changes after operation were mild and not related to outcome.

3. Maximum improvement of general anxiety occurred within the first three months, whereas phobias continued to improve after the first year.

4. Poorer outcome was associated with an anxious, shy, premorbid personality, prominent depression before operation, and disinhibition immediately after operation.

5. In long-standing cases of severe agoraphobia with prominent anxiety, modified leucotomy produced more useful sustained improvement than other forms of treatment.

Submitted on December 3, 1965




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