HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS Psychiatric Bulletin Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by MATTHEWS, K. Articles by ELJAMEL, M. S. Search for Related Content PubMed PubMed Citation Articles by MATTHEWS, K. Articles by ELJAMEL, M. S.

Status of neurosurgery for mental disorder in Scotland

Selective literature review and overview of current clinical activity

Ninewells Hospital and Medical School, Dundee, Scotland, UK

Correspondence: Professor Keith Matthews, Department of Psychiatry, Ninewells Hospital, Dundee DD1 9SY, UK. Tel: 01382 632121; fax: 01382 633923; e-mail: k.matthews{at}dundee.ac.uk

Declaration of interest K.M. has received payment for lectures on the management of depression from various pharmaceutical companies.

Background Despite the application of ablative neurosurgical treatments for intractable mental disorder throughout most of the past century, unequivocal evidence for efficacy has not been provided.

Aims To review the status of ablative neurosurgery for mental disorder and to describe the activities of the Scottish national service.

Method Relevant literature is reviewed alongside a description of recent clinical activity.

Results Neurosurgical treatment is offered to a small number of patients severely disabled by otherwise intractable mental disorder. There are inequalities in the strength of evidence to support the use of some of these procedures. The frequency and severity of adverse effects remains unclear. We are collecting data that should inform future practice.

Conclusions Modern neurosurgery can offer clinically meaningful symptom relief and improved function for ‘untreatable’ patients with chronic, severe depression and obsessive—compulsive disorder. However, follow-up studies of greater rigour are required. The potential role of non-ablative alternatives remains unclear.

This article has been cited by other articles:

				C. Ruck, A. Karlsson, J. D. Steele, G. Edman, B. A. Meyerson, K. Ericson, H. Nyman, M. Asberg, and P. Svanborg Capsulotomy for Obsessive-Compulsive Disorder: Long-term Follow-up of 25 Patients Arch Gen Psychiatry, August 1, 2008; 65(8): 914 - 921. [Abstract] [Full Text] [PDF]

				D. Christmas, C. Morrison, M. S. Eljamel, and K. Matthews Neurosurgery for mental disorder Advan. Psychiatr. Treat., May 1, 2004; 10(3): 189 - 199. [Abstract] [Full Text] [PDF]

				C. Ruck, D. Christmas, M. S. Eljamel, and K. Matthews Adverse events following neurosurgery * Authors' reply The British Journal of Psychiatry, October 1, 2003; 183 (4): 366 - 367. [Full Text] [PDF]

				K. MATTHEWS and M. S. ELJAMEL Vagus nerve stimulation and refractory depression: Please can you switch me on doctor? The British Journal of Psychiatry, September 1, 2003; 183(3): 181 - 183. [Full Text] [PDF]

				R. PERSAUD, D. CROSSLEY, and C. FREEMAN Should neurosurgery for mental disorder be allowed to die out? The British Journal of Psychiatry, September 1, 2003; 183(3): 195 - 196. [Full Text] [PDF]