Does neurosurgery for obsessive-compulsive disorder produce personality change?

Seventeen patients suffering from intractable obsessive-compulsive disorder treated with neurosurgery were assessed before surgery and a mean 10 +/- 5.1 years after surgery. Change in personality was assessed using a special 34-item schedule on patients and informants. The majority of subjects had not noted any significant changes in personality. The subjects were rated by themselves and their informants to have improved overall in the following characteristics: they were less obsessional, cried less, demonstrated a greater depth of feelings, laughed more, were more sociable, and were less anxious or dependent. Six subjects were judged by informants to have improved in their degree of obsessionality, which was distinguishable from the impact on obsessive-compulsive symptoms. The traits that showed an overall negative change were initiative/drive and energy level. Four subjects (2/4 open and 2/13 stereotactic surgery) were judged to have a negative personality change. Ratings of neuroticism, anxiety, depression, and capacity for pleasure showed significant improvement. We conclude that while most obsessive-compulsive disorder patients treated with stereotactic surgery do not experience a personality change, a small proportion report a positive or negative impact. Of note is the improvement in obsessionality in some patients, and an adverse personality change of the "frontal lobe type" in a few patients.