Since the late 1940s investigators in Russia and Europe have reported that electrosleep therapy is effective for the full spectrum of psychiatric disorders and many “psychophysiological” disorders, such as acid-peptic disease, essential hypertension, neurodermatitis etc. Few of these studies are controlled, and to date there is a paucity of double blind, controlled inquiries to aid the clinician in objective evaluation of the indications, contraindications, efficacy, and mode of application for this somatic therapy.A recent controlled study indicates that electrosleep therapy is effective for patients with prominent symptoms of anxiety, insomnia and depression. Our study was designed to test on a double blind, controlled basis the efficacy of electrosleep therapy on patients with chronic (more than 2 years) psychiatric illness unresponsive to current treatment modalities in which the prominent symptoms were anxiety, insomnia, and depression with no evidence of medical illness that could account for these symptoms.All patients received a comprehensive, systematic, diagnostic research interview with diagnoses based on criteria for scoring symptoms positive (Appendix 1) and criteria for each psychiatric syndrome involved (Appendix 2). Patients were randomly assigned to one of two groups. Group I patients received 10 active electrosleep treatments followed by 10 sham treatments over a 4-week period. Group II patients received 10 sham electrosleep treatments, followed by 10 active electrosleep treatments over a 4-week period. The Electrosone-50 unit was used and the treatments were identical to those described by Rosenthal and Wulfsohn (5).Frequent, double blind, objective and subjective ratings were done to assess clinical improvement. Follow-up ratings were done on a monthly basis for 6 months, except as noted in the paper. Results of the study clearly indicate that active electrosleep treatments have a significant improving effect on sleep, anxiety, and depression, with improvement in psychosocial adjustment. Follow-up data are less impressive. One patient sustained remission; all other patients who initially responded relapsed during the 1st month. Of these, only 2 responded to a further intensive course of electrosleep therapy, and have subsequently done well with maintenance treatments. Patients diagnosed as having primary depression consistently did worse with active electrosleep treatment.On the basis of our findings, electrosleep therapy appears to have limited value for patients with a chronic psychiatric illness manifested by prominent anxiety, depression, and insomnia. However, some patients may do better with this therapy than with other current treatment modalities. In patients will primary depression, electrosleep therapy should be used with caution, and may be contraindicated.Clearly this is a preliminary study and further systematic clinical and physiological investigation must be done before efficacy and clinical indications are established.