November 05, 2007

Mentally Ill in China Pushed into Brain Surgery as "Treatment"

A story recently published in The Wall Street Journal (WSJ) discusses brain surgeries that are being done on the mentally ill in China. According to the story many people living in China who suffer from mental health issues ranging from depression to schizophrenia are being treated with brain surgeries - an approach that has little or no support from scientific studies, and which is causing people even greater pain, suffering and financial loss.

The WSJ story begins with the example of a 25-year-old Chinese man named Mi Zhantao who recently underwent brain surgery at the recommendation of his doctors for depression and problems with socializing. Zhantao's doctors told him these were signs of schizophrenia; and so Zhantao's parents paid the required $4,800 for his brain surgery (the accumulation of four years' salaries for them). Sadly, instead of helping with Zhantao's symptoms, the operation left him with a "partially limp left arm and slurred speech."

The idea of brain surgery to treat schizophrenia or any other mental illness may seem unbelievable to residents of developed countries, but in China many physicians advocate this treatment. In fact, the hospital at which Zhantao was operated on which took place on the same day he first met his surgeon, Wang Yifang--hands out pamphlets with success stories of brain operations like Zhantao's and even has a hotline prospective patients can call with their problems.

The invasive surgery Zhantao underwent involved the insertion of a 7 and one-half inch long needle and the drilling of tiny holes in his skull. Further, and as part of the procedure, certain small areas of Zhantao's brain tissue thought to be responsible for his depression and socialization problems were then burned using the brain probe. Mr. Mi Zhantao's surgeon has performed close to 1,000 of these brain surgeries since 2004, when the No. 454 Hospital first began to offer them.

The irreversible brain surgeries performed at No. 454 Hospital, which are all but blacklisted for mental illness in the developed world, are being done across China...Some foreign doctors were shocked when told of the number of surgeries Dr. Wang has performed and the problems he was trying to treat. "It's completely off the charts. If he had done 10, it would be highly controversial," says Michael Schulder, president of the American Society for Stereotactic and Functional Neurosurgery. Such surgery involves locating and operating on specific targets in the brain.

Brain surgery for mental disorders has been a controversial practice since at least the 1930s, when doctors began performing lobotomies, removing or altering parts of the brain. That procedure was eventually blacklisted. (Nowadays,) surgeons (may) operate on the brain for problems ranging from tumors to movement disorders. But in mainstream medicine, the surgery performed on Mr. Mi -- called ablative surgery -- is a (highly controversial, rarely used) last resort for mental illness. It isn't done anywhere in the U.S. for schizophrenia. While the total number of psychosurgical procedures performed in the world is unknown, Emad N. Eskandar, of Massachusetts General Hospital, estimates fewer than 25 patients are operated on annually in the U.S. and Britain. Doctors at Massachusetts General perform between six to 12 ablative procedures a year for mental illness, but only after rigorous screening, says Dr. Eskandar, the director of stereotactic and functional neurosurgery. The operations are intended to ease symptoms of intractable depression or obsessive-compulsive disorder. Patients must be competent to give informed consent, and the procedure, which normally takes at least a year to be approved, must be cleared by a committee including psychiatrists, neurologists, ethicists, surgeons and a layperson.

The article goes on to say that the brain surgeries performed in China may be the result of the corrupt Chinese health care system in which doctors make the majority of their salaries from "bonuses tied to business they generate." The system thus becomes susceptible to abuse and in fact, according to Sun Bomin, director of functional neurosurgery at Shanghai Jiao Tong University, in the military hospitals of China, the brain center is thought of as a money generator. The lucrative nature of surgeries such as Mr. Mi's make them very profitable for the surgeons performing them.

Though the article states that China is currently trying to fix their health care system, for people like Mr. Mi, his parents and thousands of others who either underwent these controversial surgeries or are loved ones of those who did, word about the devastating effects of these surgeries can't spread quickly enough.

Full Story: The Wall Street Journal, Harsh Treatment, In China, Brain Surgery Is Pushed on the Mentally Ill

More Information:
Schizophrenia Treatments that are supported by science


The human rights of china is like that of arabs - enough said, keep taking the tiger meat.

Posted by: Nick at November 6, 2007 06:47 AM

Not overly long ago many American and British psychiatrists were ardent ultra right wing eugenicists and had a total contempt for human rights.

Posted by: Tim at November 6, 2007 08:57 AM

Lobotomies were all the rage when I was born..Seems I missed that horror by a generation..

Posted by: Salty Davis at November 6, 2007 11:18 AM

Although I am bitter about failing a psychiatric evaluation for an armed officer position when I was on 7.5 mg Zyprexa instead of 5mg, once again it would behoove me to be thankful to my country for the opportunities I have had as a young mentally ill man.

Posted by: hmmned at November 9, 2007 01:21 PM

I come from China,
As I know from the news report, only the patient showing harshly manic phenomena,
such as demolishing articles, scolding and beating the relatives and people around him,
on the occasion that other treatments are not able to alleviate and remedy,
A surgical operation would possibly be taken, aimed to release the severity of mania symptoms.
While in the brain hospital, the therapy to serious depression is MECT (Modified Electric Convulsive Therapy).
And, every country has its own problems and advantages,
which are not capable of being understood by one or two casual and facile utterances.

Posted by: Tommy at February 22, 2008 06:36 PM

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