Division of Neurosurgery, Hospital das Clínicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Neuropsychiatr Dis Treat. 2013;9:509-15. doi: 10.2147/NDT.S35823. Epub 2013 Apr 15.
Following the early studies of Moniz and Lima, psychosurgery had considerable scientific credibility until the advent of modern antipsychotics in the mid 1950s. Thereafter, psychosurgery was almost abandoned in large medical centers as a common treatment for schizophrenia, although is still used for some affective and anxiety disorders. We reviewed relevant papers cited in the Medline/Index Medicus, Cochrane, and Scielo databases from 1930 to 2012. In our review of the literature, we show from recent studies that there are still many patients with schizophrenia who have serious deficits even after being treated with current noninvasive therapies. The value of psychosurgery remains controversial. There are no data available to support the use of stereotactic procedures for schizophrenia. Well designed controlled trials are needed to establish the effectiveness of psychosurgery in patients with schizophrenia.
继 Moniz 和 Lima 的早期研究之后，精神外科在相当长的一段时间内都具有相当的科学可信度，直到 20 世纪 50 年代中期现代抗精神病药物的出现。此后，精神外科在大型医疗中心几乎被弃用，不再作为精神分裂症的常规治疗方法，尽管它仍被用于一些情感和焦虑障碍。我们回顾了 1930 年至 2012 年期间 Medline/Index Medicus、Cochrane 和 Scielo 数据库中引用的相关论文。在对文献的回顾中，我们从最近的研究中表明，即使在接受了当前的非侵入性治疗后，仍有许多精神分裂症患者存在严重的缺陷。精神外科的价值仍然存在争议。目前尚无数据支持立体定向手术治疗精神分裂症。需要进行精心设计的对照试验来确定精神外科对精神分裂症患者的有效性。
