In the shadow of the “psychopharmacological revolution”: Malaria fever, insulin coma, cardiazol and electroconvulsive therapy at the Vienna Psychiatric University Clinic, 1951–1969

The study presents the results of a 2-year research project on the therapeutic practices in psychiatry at the University Clinic of Vienna under the leadership of Hans Hoff from 1951 to 1969. Hoff took over as Head of the Department of Psychiatry and Neurology shortly after his return to Vienna from whence he had had to flee after Austria's "Anschluss" (annexation) to Nazi Germany in 1938 because of his Jewish background. The focus of the investigation was on the extent, methods and justifications for the application of four highly invasive somatic treatments, which were developed during the interwar period and continued to be practiced at the Vienna Clinic during the years under study. These treatments included electroconvulsive therapy (ECT), cardiazol-induced convulsion therapy, insulin coma therapy and malaria fever therapy, the latter also used beyond its traditional application for neurosyphilitic conditions. The study analyzes the medical records of patients from the adult departments (aged 15 years and older) who were diagnosed with neurosyphilis, intellectual disabilities, schizophrenia, affective disorders, or psychopathy (a total of 14,919 patient records). Additionally, it examined how these therapies were discussed in professional publications from Austria, Switzerland, Germany, France, and Great Britain, and to what extent their application was considered state-of-the-art during the transition to new pharmacological treatments.