Neurosurgery for mental disorders (NMD) A clinical worldwide perspective: past, present and future.

The use of neurosurgery for mental disorders (NMD) is a clinical issue that involves many ethical considerations. It is a treatment that offers hope for many patients with severe and debilitating affective and anxiety disorders and should be widely available. Its current use worldwide (UK, Sweden, US, Australasia, Europe) is reviewed and the types of procedures currently used are explained (stereotactic subcaudate tractotomy, anterior capsulotomy, cingulotomy, limbic leucotomy). In addition, clinical strategies for the evaluation and management of patients both prior to and following NMD are discussed.