Modified Leucotomy in Severe Agoraphobia: A Controlled Serial Inquiry

There is still little agreement on the value of frontal leucotomy in the treatment of chronic psychiatric illness (Pippard, 1962). A familiar feature of this uncertainty is the contrast between the enthusiasm of the authors of uncontrolled studies (Pippard, 1955; Scoville, 1960; Sargent and Slater, 1963; Birley, 1964; Sykes and Tredgold, 1964) and the scepticism of those who have included a matched untreated group (Robin, 1958; McKenzie and Kaczanowski, 1964; Brit. Med. J., 1965). These controlled series were only concerned with “standard” leucotomies, which are now generally abandoned. All studies, including those of modified leucotomy, examined heterogeneous psychiatric disorders and concentrated on their final state rather than their progress towards it. This approach may obscure important differences both in type of disorder and stage of follow-up.