The rorschach analysis of psychotics subjected to neurosurgical interruption of the thalamo-cortical projections

Summary

The Rorschach form-perception test was used preoperatively and postoperatively, whenever conditions permitted, in a series of 20 psychotic patients subjected to therapeutic bilateral prefrontal lobotomy. A continuing clinical followup was made on each patient for periods ranging up to one year. Because of the severe psychotic subjects with whom we were dealing, and other factors tending to reduce the number of cases available for reliable comparative studies, it was not possible to compute quantitative relationships on the basis of age, sex, or diagnosis. Qualitatively, the study revealed that the changes from preoperative records to postoperative records are not very large, in most cases, and that atypical signs present in the postoperative records are frequently anticipated in the preoperative records. In the postlobotomy course, Rorschach improvement may, or may not, run parallel with clinical improvement. An analysis of the postoperative scoring signs revealed the presence of several of Piotrowski’s criteria of intracranial damage, but since they frequently appeared in the preoperative picture, it was felt that they were more a function of the psychotic processes than of the lobotomy. In general, it appears that the neurosurgical transection of the frontal association areas plays a less important rôle in the reorganization of the Rorschach patterns than does the prepsychotic and preoperative personality structure.