Treatment of social phobia by endoscopic thoracic sympathicotomy.

OBJECTIVE To analyse the severity of various symptoms and the developmental life history in social phobia. To estimate the value of ETS in the treatment of chronic social phobia. DESIGN Prospective study. SETTING Clinic for Psychoneurology and Surgery in Tampere, Finland. SUBJECTS Consecutive series of patients (n = 51). INTERVENTIONS Endoscopic thoracic sympathicotomy. MAIN OUTCOME MEASURES Qualitative ideographic inquiry. Questionnaire of the symptom severity using visual analogue scale. RESULTS The life history included mental and physical abuse in 61%, paternal alcoholism in 26%. Four family subtypes were named: quarrelsome, cruel, alcoholic, and perfectionist. The pathognomonic symptoms of social phobia: hyperhidrosis, palpitation, blushing, tremor, and anxiety, were all highly significantly (p < 0.001) alleviated by ETS. 88% of the patients were satisfied with the result. There were no complications. CONCLUSION ETS seems a promising alternative to conservative therapy for social phobia.