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LATE RESULTS OF ORBITAL UNDERCUTTING Report of 76 Patients Undergoing Quantitative Selective Lobotoimies
WILLIAM BEECHER SCOVILLE
Am J Psychiatry 1960;117:525-532.
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Abstract

1. Psychosurgery continues to have definite applications, especially in the involutional and cyclic depressions, the agitated states of the elderly, the better preserved schizophrenics, and the intractable psychoneuroses, especially when suffering from anxiety or tension.2. It is preferred to shock treatment in those depressions requiring more than short courses of shock treatment because of less emotional blunting, memory loss and relapses.3. Agitated depressed senile states react more favorably to limited lobotomy operations than those in the younger age group.4. Complete lobotomy has been replaced by limited selective operations. Undercutting of the orbital cortex offers the advantage of a precise technique under direct vision in an area causing appreciable lift in mood, lessening of anxiety and a minimum personality blunting.5. The late results in orbital undercutting when studied in the separate categories of depressions, agitated senile states, schizophrenia, pseudoneurotic schizophrenia and intractable psychoneurosis have in most cases continued to show an improvement rather than regression or relapse. It has done so to a far greater degree than was anticipated, especially in schizophrenic patients of high cultural background.6. Complications, including seizure formation, occur in the early rather than the late follow-up studies.

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