Use of leucotomy for intractable anorexia nervosa: A long-term follow-up study

Objective: We studied the long-term outcomes of intractable anorexia nervos a treated with leukotomy and specialized psychotherapy over 20 years ago. M ethod: All traceable subjects were interviewed using the Eating Disorders E xamination (EDE) and the Structured Clinical Interview for DSM-III-R (SCID) . They also completed questionnaires. Detailed histories were taken. Result s: Four of five female subjects were traced. Their cases had been severe, w ith failure of previous intensive psychotherapy and now with high risk of d eath from terminal inanition. One patient had committed suicide, whereas th e of hers enjoyed a reasonable quality of life. Persistent core psychopatho logy was evident, but patients had not succumbed to weight loss. All suffer ed depression and anxiety-related disorders, but endorsed their treatment, which had allowed sustained weight gain by release of appetitive behavior, provision of a license to change, and alleviation of phobic anxiety, allowi ng psychotherapeutic engagement. Discussion: We argue that these outcomes a re relatively favorable and would not have been possible without this latte r engagement in specialist psychotherapy to address burgeoning panic at una voidable weight gain. (C) 2000 by John Wiley & Sons, Inc.