INVOLUTIONAL MELANCHOLIA AND CONVULSIVE THERAPY

Results of 61 involutional cases discharged from the Institute of Living, 1935-37, prior to convulsive therapy, are compared with those of 347 involutional cases treated with convulsive therapy between 1945 and 1947. The average number of electric treatments for melancholia cases was 10.8; for paranoid cases, 16.2; for mixed cases, 11.8. In both series of preshock and shock eras, the patients benefited from estrogen therapy and the reeducational and vocational programs, the latter with progressively increased facilities.

The average duration of hospital stay was 1½ years in the preshock era as compared to 6 months with convulsive therapy.

The combined percentage of patients recovered and improved was essentially the same in both series (92% in 1935-37 and 90% in 1945-47). However, in the preshock era, 30% of melancholia cases were considered as recovered as compared to 62.5% of those receiving convulsive therapy; 62% were considered as improved as compared to 27.5% with convulsive therapy. The criteria of recovery not being the same in both series, these latter figures cannot be compared without reservation. However, even allowing for the difference in criteria of what constitutes recovered, there is material evidence to indicate that the shock-treated group left the Institute in better condition than the nonshock group. On the other hand, there is conclusive evidence that the length of stay in the combined recovered and improved group was materially shortened. The non-shock-treated group remained in the Institute on an average of 3 times as long as the shock-treated group. This difference in the length of hospitalization can hardly be accounted for by the improved and increased ancillary therapies which had undergone considerable development with the shock-treated group.