While many theories about the mode of action of electroshock therapy have been offered, the relationship among neurophysiological and psychological factors remains poorly understood.* Although changes in brain function may be demonstrated on electrical recording, such evidence of impaired function has not been correlated with the degree of psychiatric improvement. Similarly, although memory defects and impaired learning ability are common manifestations following the administration of electrically induced convulsions, their severity is not an index of therapeutic outcome. It would appear that the results of ordinary clinical and laboratory procedures and psychological tests do not furnish adequate criteria for a correlation of the alterations of behavior with the changes in brain function.
In previous studies3 it has been suggested that the therapeutic action of electroshock therapy was related to the production of a milieu of brain dysfunction in which denial of illness (anosognosia) might occur. A concept of anosognosia was
ROBERT L. KAHN, MAX FINK, EDWIN A. WEINSTEIN. Relation of Amobarbital Test to Clinical Improvement in Electroshock. AMA Arch NeurPsych. 1956;76(1):23–29. doi:10.1001/archneurpsyc.1956.02330250025003