An estimated 40,000 to 50,000 lobotomies were performed in the United States between the late 1930s and the mid-1970s. Worldwide, the total climbs significantly higher, with tens of thousands more carried out across Europe, particularly in the United Kingdom and Scandinavia. The procedure’s rise and fall spans roughly four decades, driven by desperation in psychiatric care, a Nobel Prize, and the eventual arrival of psychiatric medications.
The Numbers in the United States
The vast majority of lobotomies took place in the U.S., where the procedure gained enormous popularity in the 1940s and 1950s. Walter Freeman, the neurologist who became the procedure’s most aggressive champion, personally performed or supervised around 3,500 lobotomies across 23 states. Freeman popularized a faster version of the surgery that could be done in minutes using an instrument resembling an ice pick, inserted through the eye socket. This “transorbital” technique didn’t require a traditional operating room, which meant it could be performed in state psychiatric hospitals that had no surgical facilities.
The peak years were roughly 1949 to 1952, when thousands of procedures were performed annually. State mental hospitals were overcrowded, often housing patients in horrific conditions, and lobotomy was embraced as a way to make unmanageable patients docile enough to be discharged or at least easier to care for.
Lobotomy Across Europe
The procedure originated in Europe. Portuguese neurologist Egas Moniz performed the first leucotomy (the European term for lobotomy) in 1935, targeting the connections to the front part of the brain to reduce severe psychiatric symptoms. In 1949, Moniz received the Nobel Prize in Physiology or Medicine “for his discovery of the therapeutic value of leucotomy in certain psychoses,” a decision that remains controversial to this day.
Norway documented 2,005 lobotomies in total, a striking number for a country with a small population. The Norwegian government later established a compensation program for surviving patients. In England and Wales, the procedure persisted longer than many people realize: 119 operations were still being performed as late as 1974, with numbers gradually dropping to around 20 per year by the 1990s. Scandinavian countries, including Sweden and Finland, also performed lobotomies at relatively high per capita rates, though precise national totals are harder to pin down.
Across all countries combined, estimates of the global total range from roughly 70,000 to over 100,000 procedures, though incomplete record-keeping in many institutions makes an exact count impossible.
Who Was Lobotomized
Women made up a disproportionate share of lobotomy patients. A study of one Swedish state hospital found that 61.2% of lobotomized patients were women. Schizophrenia was the most common diagnosis leading to the procedure, but the indications were remarkably broad. Patients with severe depression, anxiety, obsessive-compulsive disorder, and chronic pain were all considered candidates. In some rare cases, lobotomy was even performed on patients with peptic ulcers or inflammatory bowel disease in an attempt to stop gastrointestinal bleeding, reflecting how loosely the procedure’s rationale was applied.
Veterans’ hospitals performed large numbers of lobotomies on soldiers returning from World War II with what would now likely be diagnosed as PTSD. Children and teenagers were also lobotomized in some cases, as were people whose behavior was simply considered socially unacceptable. The lack of meaningful informed consent for most patients, many of whom were institutionalized and had no legal advocate, is one of the lasting ethical stains on the procedure’s history.
What Lobotomy Actually Did
The surgery severed or destroyed connections between the prefrontal cortex and the rest of the brain. The prefrontal cortex is the region responsible for personality, planning, decision-making, and emotional regulation. Cutting those connections could reduce agitation, aggression, and emotional distress, but it often came at a devastating cost.
Patients frequently emerged from the procedure with blunted emotions, reduced motivation, and impaired ability to function independently. Some became incontinent or childlike in their behavior. Personality changes were so common they were essentially expected. Moniz himself had observed that lobotomized patients could still identify pain but no longer seemed to care about it, which was seen as a feature rather than a side effect. Mortality rates varied by surgeon and technique, but roughly 1.5% to 5% of patients died from the procedure, and many more were left permanently disabled.
Why the Numbers Dropped
The introduction of chlorpromazine in 1954, marketed under the brand name Thorazine, transformed psychiatric treatment almost overnight. It was initially described as a “chemical lobotomy” because it produced similar calming effects without surgery. For the first time, doctors had a tool that could reduce psychotic symptoms, agitation, and hallucinations with a pill rather than an irreversible brain operation.
The availability of medication alone didn’t end the practice. Growing public discomfort played a major role, fueled by media coverage of lobotomy’s worst outcomes and by the broader civil rights movement’s attention to the treatment of institutionalized people. By the late 1950s, the number of lobotomies performed in the U.S. had dropped sharply. Most countries had largely abandoned the procedure by the 1970s, though a small number of modified psychosurgeries continued to be performed into the 1980s and beyond.
Modern Psychosurgery
Psychosurgery did not disappear entirely. A handful of highly specialized procedures still exist for patients with severe, treatment-resistant psychiatric conditions, but they bear little resemblance to the lobotomies of the mid-20th century. Modern techniques target extremely precise brain areas using advanced imaging, and they destroy only tiny amounts of tissue. These procedures are rare, typically numbering in the dozens per year worldwide, and they require extensive ethical review, informed consent, and documentation that a patient has failed to respond to all other available treatments.