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September 1954

INFLUENCE OF E. C. T. AND INSULIN COMA ON LEVEL OF ADRENOCORTICAL STEROIDS IN PERIPHERAL CIRCULATION

AMA Arch NeurPsych. 1954;72(3):352-361. doi:10.1001/archneurpsyc.1954.02330030086010
Abstract

THE VALUE of insulin coma and electroshock in the treatment of certain schizophrenic conditions and major affective disorders is well established. Despite the wide application of these procedures, the exact mechanisms of action responsible for therapeutic success are obscure.1 The recent interest and important advances in the field of adrenocortical physiology, combined with the conceptualization of a "general stress" theory,2 have influenced many investigators to study the effect of these "shock" procedures upon adrenocortical activity.*

All previous reports have been based upon changes in nonsteroid constituents of the plasma, alterations in the number of circulating lymphocytes and eosinophiles, or variations in the end-products of steroid metabolism found in the urine.* As all of these measurements are indirect and often unreliable indications of adrenocortical activity, it seemed important to reexamine this problem, using the technique of Nelson and Samuels for 17-hydroxycorticosteroids (17,21-dihydroxy-20-ketosteroids) in blood.24 Since 17-hydroxycorticosterone (Compound F)

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