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Am J Psychiatry 95:1349-1257, May 1939
doi: 10.1176/appi.ajp.95.6.1349
© 1939 American Psychiatric Association
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THE THERAPEUTIC SIGNIFICANCE OF FEAR IN THE METRAZOL TREATMENT OF SCHIZOPHRENIA

Louis H. Cohen M. D.1

1 The Research Service of the Worcester State Hospital, Worcester, Mass.

A method is described in which a physiological state, similar to if not identical with "fear" is induced. It has been employed in a series of 20 cases to investigate and compare the relative therapeutic significance of "fear" with the usual convulsant procedure in the metrazol treatment of schizophrenia. The method consists essentially of the slow intravenous injection of minimal amounts of metrazol. The "fear" states induced in this manner have a duration of a few minutes to several hours. The incidence of convulsive seizures can in this manner be fairly well controlled. In a group of 20 schizophrenic patients in whom this procedure was carried out on 10 successive days the therapeutic outcome after 1 month was compared with the same group treated with 10 daily convulsive seizures. The "fear of treatment" characterizing some patients was also studied in both procedures. It was shown that the procedure with "induced fear" was of less therapeutic value than that characterized by convulsions. Furthermore, the "fear of treatment" which has been differentiated from "induced fear" was again shown to be of little or no therapeutic significance.




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