The birth of convulsive therapy revisited: A reappraisal of László Meduna's first cohort of patients

Brigitta Baran, I. Bitter, Gabor S. Ungvari, G. Gazdag

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The introduction of convulsive therapy (COT) was undoubtedly one of the milestones in the history of psychiatry. Its originator, László Meduna, has become one of the founding fathers of biological psychiatry. Methods: In his first major publication on COT, Meduna described the short-term treatment outcome of the first 26 schizophrenia patients who underwent camphor- or cardiazol-induced COT; 10 improved significantly, 3 appeared slightly improved, and 13 were unimproved. The original medical notes of 23 of the 26 patients were recently recovered and the patients re-diagnosed by the authors employing ICD-10 criteria. Results: The diagnosis of schizophrenia was confirmed in 15 cases (all but two of them involving prominent catatonic symptomatology), while 2 cases met diagnostic criteria for schizoaffective disorder, 3 for Bipolar Affective Disorder (BAD) with psychotic features, 1 for psychotic depression, and 1 for Acute and Transient Psychotic Disorder (ATPD). In a final case, the most probable diagnosis was schizophrenia. Scrutiny of the notes revealed that 4 schizophrenia patients evidenced slight improvement on COT and in one case the improvement was only transient. A limitation of this study is that the quality of the original files varied considerably and the re-evaluation was done retrospectively. Conclusions: A very broad concept of schizophrenia in the 1930s explains the discrepancy between the original and the revised results. In line with the current views on the effectiveness of electroconvulsive therapy, catatonic symptoms, but not the core schizophrenic process, showed some improvement while all ATPD, BAD and depressed patients responded to COT.

Original languageEnglish
Pages (from-to)1179-1182
Number of pages4
JournalJournal of Affective Disorders
Volume136
Issue number3
DOIs
Publication statusPublished - Feb 2012

Fingerprint

Convulsive Therapy
Schizophrenia
Parturition
Psychotic Disorders
Mood Disorders
Bipolar Disorder
Biological Psychiatry
Camphor
Pentylenetetrazole
Electroconvulsive Therapy
International Classification of Diseases
Fathers
Psychiatry
Publications
History
Depression

Keywords

  • Affective disorder
  • Convulsive therapy
  • László Meduna
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

The birth of convulsive therapy revisited : A reappraisal of László Meduna's first cohort of patients. / Baran, Brigitta; Bitter, I.; Ungvari, Gabor S.; Gazdag, G.

In: Journal of Affective Disorders, Vol. 136, No. 3, 02.2012, p. 1179-1182.

Research output: Contribution to journalArticle

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