Electrical treatment of anxiety states.

Fifty patients who were suffering from anxiety states were treated by subconvulsive electrostimulation through bi-temporal electrodes under pentothal anaesthesia. In the first 25 of these cases, the frequency of stimulation was 500 pulses per second; the remaining 25 were treated by stimulation at the lower frequency of 200 p.p.s.

Fifty similar cases, likewise divided into two equal groups, acted as controls. They received a course of placebo “treatments”, which also included pentothal anaesthesia. No other discrimination was exercised between the Treatment and the Control groups.

Each Treatment group was matched with the corresponding Control group on the basis of the type of anxiety state, according to a simple classification. To prevent prejudice, the classified patients were divided into the Treatment and Control groups by an independent observer and on the basis of alternate selection within each Type.

The average course consisted of 12 treatments or of the same number of control “treatmeats”. In addition, each patient received psychotherapy from his own physician. No attempt was made to foster electrostimulated abreactions for psychotherapeutic purposes.

Two psychometric tests were performed on each patient both before and after the treat ment period. The patients were also subjected to Funkenstein's test of autonomic reactivity on both occasions. A follow-up was conducted by questionnaire after an interval of not less than three months following the patient's discharge.

The assessor, the psychologist, and the patients' own physicians were all unaware of the groupings of the patients. Unfortunately, however, these had to be made known to the assessor before the follow-up reports were interpreted. Each patient was therefore asked, in addition, to make a sell-assessment,which was used as a check.

The results indicated that: 

1. There was no significant difference in clinical response between the 50 treated cases and the 50 controls, during the period of observation.

2. At one point there was a significant difference between one Treatment group and the corresponding Control group. However, this difference, which was in favour of the Treatment group, was only observed in the assessor's interpretation of the follow-up reports, and there were reasons for believing that it was unrelated to the treatment.

3. There was a significant association between each psychometric test and the immediate clinical findings. Furthermore, neither test revealed any difference between the sub-groups. Surprisingly, however, no agreement was found between the two tests, and it was concluded that they probably measured different traits.

4. The reaction to adrenaline, in Funkenstein's test, was associated very significantly with the clinical findings in those patients who had adrenaline-precipitable anxiety.

5. The reaction to adrenaline was of no prognostic significance. Patients who had adrenaline-precipitable anxiety stood a similar chance of improving as those who did not.

6. The reaction to Amechol provided no evidence that electrostimulation enhanced depressive features.

7. Regardless of their groupings, nearly half of the patients were found to be much improved immediately after the treatment period, and more than a third of them maintained their improvement for at least three months. While these results leave much to be desired, any new form of treatment must be able to better them substantially before it can be considered to be of any therapeutic value.

Field of study: Medicine, Psychology