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The outcome of all psychosurgical operations (stereotactic subcaudate tractotomies) performed at the Geoffrey Knight National Unit for Affective Disorders in London since 1979 is reviewed. Of patients who had suffered severe mood or obsessive-compulsive disorders before surgery, 84 of 249 (34%) were well 1 year after. The effects of gender, psychiatric diagnosis, and age on outcome are assessed. The findings are compared with a 1975 outcome study, and explanations for apparent differences are proposed.

On 28 March 1990 a BBC television programme in the ‘QED’ series was broadcast entitled ‘The Last Resort’. It sympathetically showed the life of a woman with a treatment resistant affective disorder and later presented some aspects of her treatment at this unit, including a stereotactic subcaudate tractotomy (SST) operation. As a result of this programme a number of patients wrote to us and this report compares referrals arising in this way with a sample of referrals to the unit through the usual channels.