In this study, endoscopic sympathetic block was useful in reducing the symptoms of
severe social phobia. Although the method is surgical and the effect hence mainly biolog-
ical, the psychological symptoms of social phobia were also significantly reduced. The
results are best if the main symptoms are blushing or palpitation, but even a smaller
reduction in the other symptoms is important if it helps the patient to break his isolation.
Knowledge of the elimination of embarrassing physical symptoms in social situations
helps the patient to expose himself to formerly impossible situations, and success in them
also causes psychological symptoms to subside. But the relief of psychological symp-
toms may also be due to direct a biological effect of the operation on the anxiety-mediat-
ing areas in the nervous system. The only meaningful side effect is compensatory sweat-
ing of the trunk, but not even that is significant when modern surgical method are used.
Clamping is as good as bilateral cauterisation, and the results may be equally good with
unilateral and bilateral clamping, but because there were only eight patients who had
undergone a unilateral clamping procedure, the material is not sufficient to allow definite
conclusions concerning that. The results remain unchanged over time, which shows that
they were not due to a placebo effect. In the future, it is important to compare this treat-
ment to traditional treatment in order to find out its place among the other, officially
approved methods of treating social phobia.
PÄIVI
POHJAVAARA
Faculty of Medicine,
Department of Psychiatry,
University of Oulu
OULU 2004
