Further appraisal of the adrenalin-mecholyl test (Funkenstein test).

Abstract

Summary The Funkenstein adrenalin-Mecholyl test was administered to 46 hospitalized psychiatric patients. In 22 subsequent cases, only the Mecholyl was administered, since in our series this seemed the only meaningful portion of the test. The Funkenstein test groups were correlated with clinical estimates of adequacy of affect and it was found that the groups with a hypotensive response to Mecholyl (Groups V-VI) had a significantly higher percentage (80 per cent) of adequate and appropriate affect than the hypertensive groups (Groups I-IV), only 48 per cent of which had adequate affect. The Funkenstein test groups were also correlated with clinical outcome in our series, where the principal mode of treatment was psychotherapy; it was found that the hypotensive response groups (Groups V-VI) had a significantly higher improvement rate (78 per cent) than the hypertensive groups (48 per cent). Finally, clinical outcome was correlated with clinically estimated affect without respect to the Funkenstein groups, and here it was found that improvement rate in patients with adequate affect was 74 per cent, whereas only 32 per cent of patients with inadequate affect showed improvement. The positive correlation between adequacy of affect and clinical improvement was particularly marked in Groups I-IV, where 90 per cent of cases with adequate affect improved, whereas only 9 per cent of cases with inadequate affect showed improvement. None of these findings is advanced as reliable indicators in long-term prognosis until outcome of follow-up studies can be assayed. The psychophysiological significance and several conflicting explanations of the Mecholyl responses are discussed.