A prospective, long-term study of personality traits in patients with intractable obsessional illness treated by capsulotomy

• Published in: Acta psychiatrica Scandinavica Vol. 99; no. 1; pp. 40 - 50
• Main Authors: MINDUS, P, EDMAN, G, ANDREEWITCH, S
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 1999
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Anxiety disorders. Neuroses; Biological and medical sciences; Female; Follow-Up Studies; Frontal Lobe - surgery; Humans; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Obsessive-Compulsive Disorder - complications; Obsessive-Compulsive Disorder - psychology; Obsessive-Compulsive Disorder - surgery; Obsessive-compulsive disorders; Personality Disorders - complications; Personality Disorders - diagnosis; Personality Disorders - psychology; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychosurgery; Time Factors; Human; Postoperative; Obsessive compulsive disorder; Capsulotomy; Personality change; Surgery; Anxiety disorder; Psychosurgery; Complication
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/j.1600-0447.1999.tb05383.x

The crux when contemplating neurosurgery for otherwise intractable mental illness is whether there is a price which the patient may have to pay, in terms of adverse personality changes, for symptom relief. In the present study of 19 patients undergoing thermo-capsulotomy for intractable obsessional illness, personality characteristics were studied pre-operatively, and at 1-year and 8-year follow-up, using the Karolinska Scales of Personality (KSP). Small mean score changes toward normalization were apparent on all 15 KSP scales at the 1-year follow-up, and significant improvements in anxiety proneness were noted at the 8-year follow-up. One patient who sustained a surgical complication showed deviant postoperative scores on scales related to psychopathic traits. There were no such deviant scores for the remaining subjects. The incidence of adverse personality changes following capsulotomy is low and does not increase with time. This conclusion, based on groups of patients, does not of course preclude the possibility that adverse personality changes may occur in individual patients.