Psychosurgery and personality disorders

Defining personality and its pathological variants is a hazardous enterprise. The personality concept refers to the global coherence of functioning of a person as a whole and can be divided into two components, temperament and character. Personality disorders will be discussed according to the DSM III-R (1987) (The Diagnostic and Statistical Manual of Mental Disorders) the most recent psychiatric taxonomy of the American Psychiatric Association. The interaction between psychosurgery and personality is multiple. It will be stated that the mere presence of a personality disorder in a patient should never be an indication for psychosurgery. It may sometimes even act as a contraindication. Psychosurgery can produce changes in some basic psychic dysfunctions and although there is no universally accepted understanding of how it works, some hypothetical neurobiological foundations will be discussed.