Bioethics Policy Study Group, Minato-ku; and.
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Neurosurg Focus. 2017 Sep;43(3):E13. doi: 10.3171/2017.6.FOCUS17255.
In Japan, there has been no neurosurgical treatment for psychiatric disorders since the 1970s. Even deep brain stimulation (DBS) has not been studied or used for psychiatric disorders. Neurosurgery for psychiatric disorders has been thwarted by social taboos for many years, and psychiatrists today seem to simply ignore modern developments and therapies offered by neurosurgery such as DBS. As a result, most patients and their families do not know such "last-resort" options exist. Historically, as in other countries, frontal lobotomies were widely performed in Japan in the 1940s and 1950s, and some Japanese neurosurgeons used stereotactic methods for the treatment of psychiatric disorders until the 1960s. However, in the 1960s and 1970s such surgical treatments began to receive condemnation based on political judgment, rather than on medical and scientific evaluation. Protest campaigns at the time hinged on the prevailing political beliefs, forming a part of the new "left" movement against leading authorities across a wide range of societal institutions including medical schools. Finally, the Japanese Society for Psychiatry and Neurology banned the surgical treatment for psychiatric disorders in 1975. Even today, Japan's dark history continues to exert an enormous negative influence on neurosurgery for psychiatric disorders.
在日本，自 20 世纪 70 年代以来，就没有针对精神疾病的神经外科治疗方法。甚至深部脑刺激（DBS）也没有被用于研究或治疗精神疾病。多年来，精神疾病的神经外科治疗一直受到社会禁忌的阻碍，如今的精神科医生似乎只是简单地忽略了神经外科提供的现代发展和治疗方法，如 DBS。因此，大多数患者及其家属并不知道存在这样的“最后手段”。从历史上看，与其他国家一样，在 20 世纪 40 年代和 50 年代，日本广泛地进行了额叶切断术，一些日本神经外科医生在 20 世纪 60 年代之前使用立体定向方法治疗精神疾病。然而，在 20 世纪 60 年代和 70 年代，此类手术治疗开始受到基于政治判断而不是医学和科学评估的谴责。当时的抗议活动基于当时盛行的政治信仰，是反对包括医学院在内的广泛社会机构的主导当局的新“左派”运动的一部分。最终，日本精神病学和神经病学学会于 1975 年禁止对精神疾病进行手术治疗。即使在今天，日本的黑暗历史仍在继续对精神疾病的神经外科治疗产生巨大的负面影响。
