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The working titles of this film were The Silence of Helen McCord and Some Must Watch. According to a Hollywood Reporter news item, RKO acquired the rights to Ethel Lina White's novel from David O. Selznick's Vanguard Films. In a memo reproduced in a modern source, Selznick states that the literary rights were part of a package sold to RKO under a partnership agreement between the studio and Vanguard. According to the terms of that agreement, Selznick furnished the novel and the services of producer Dore Schary, director Robert Siodmak and stars Dorothy McGuire and Ethel Barrymore in exchange for a split of the profits. In a modern interview, McGuire stated that the eye seen in close-up in the film, supposed to be that of "Professor Albert Warren" (George Brent), was actually that of director Robert Siodmak.
Barrymore was nominated for an Academy Award as Best Supporting Actress for her work on this picture. Assistant director Harry Scott died on October 10, 1945, while working on the film. The 1975 British film The Spiral Staircase, starring Jacqueline Bisset and Christopher Plummer and directed by Peter Collinson, was also based on White's novel. In 1961, NBC broadcast a televised version of White's novel titled The Spiral Staircase, starring Lillian Gish, Gig Young and Eddie Albert and directed by Boris Sagal. Another adaptation of the novel was broadcast on the Fox Family Channel in 2000. That version starred Nicolette Sheridan and Judd Nelson and was directed by James Head.