الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The evolution of psychiatric theories for mental illness gives a comprehensive idea about the etiological factors of psychiatric disease focusing on the functional and behavioral neuroanatomical and neurobiological causes which may give an opportunity for understanding why surgery become an attractive option for treatment of chronic psychiatric illness.
The first consistent technique for psychosurgery was developed by Egas Moniz, in 1935, called leucotomy, with the appearance of effective drugs against anxiety, depression and psychoses as chlorpromazine, and with the evidence of its widespread abuse, lobotomy and other forms of leucotomy were declined in that decade, and are no longer performed. Nevertheless, some patients failed to respond to appropriate pharmacological therapy and referrals to specialized centers for neurosurgical intervention continued.
There are different techniques of neurosurgical procedures; transorbital leucotomy, rostral leucotomy, subcaudate tractotomy, anterior cingulotomy, limbic leucotomy, anterior capsulotomy, amygdalotomy, hypothalamoyomy and other procedures.
The ethical objections in the use of psychosurgery have been mentioned by insuring on the informed consent from the patient and family to protect the patient from hazardous and abusing psychosurgery.
Modern neurosurgery of mental illness with less hazardous reversible interventions as vagus nerve stimulation, deep brain stimulation and radiosurgery “gamma knife procedures”. They are effectively modifying brain function to relieve suffering and to improve the quality of life in these severe and treatment-refractory cases.Future direction of psychiatric surgery as stem cell implantation may give a hope to ameliorate various psychiatric illnesses as Alzheimer disease and autism.
Currently the accepted therapeutic approach to most psychiatric disease involves a combination of psychotherapy, pharmacotherapy and, in some instances, electroconvulsive therapy. However, despite these modern treatment methods, some patients fail to respond adequately and remain severely disabled. In these patients, surgical intervention might be considered appropriate. But following surgery, the patient should be under care, follow up and takes combined courses of psychotherapy and psychopharmacology.