title: Severe anorexia nervosa, co-occurring major depressive disorder and electroconvulsive therapy as maintenance treatment: a case report.
abstract: BACKGROUND
  It is difficult to treat patients who, in addition to having severe anorexia nervosa, also have severe symptoms of major depressive disorder and a tendency for impulsive acting out behaviour. Our case report considers the feasibility of maintenance electroconvulsive therapy in such complicated cases.
  
  
  METHODS
  This is a case report of a woman with anorexia nervosa and co-morbid severe major depressive disorder who was treated with electroconvulsive therapy as a maintenance treatment. The maintenance electroconvulsive therapy was conducted without immediate complications. It had a positive effect on the patient's depressive symptoms and lability and her general wellbeing, although some cognitive deficits were observed.
  
  
  CONCLUSIONS
  The maintenance electroconvulsive therapy seemed to support recovery in a case of refractory anorexia nervosa and a tendency for labile mood. The symptoms of co-occurring major depressive disorder were partly relieved and maintenance electroconvulsive therapy had some positive effect on weight gain.
authors.affiliation: Department of Psychiatry, Tampere University Hospital, 33380 Pitkaniemi, Finland.
authors.forename: Outi
authors.initials: O
authors.lastname: Poutanen
authors.forename: Kaija
authors.initials: K
authors.lastname: Huuhka
authors.forename: Kaisa
authors.initials: K
authors.lastname: Perko