Electroconvulsive therapy in an adolescent with autism and bipolar I disorder.
OBJECTIVE
We report a positive response to electroconvulsive therapy in a severely functionally impaired adolescent with autistic disorder and classic bipolar I disorder, including an episodic pattern of decreased need for sleep, hypersexuality, expansive and agitated affect, aggression, self-injury, and property destruction.


METHODS
After ineffective trials of mood stabilizers and antipsychotics as well as inability to sustain a positive response to lithium due to medication noncompliance, a course of acute and maintenance electroconvulsive therapy was attempted.


RESULTS
A marked and sustained improvement across all symptom categories, as measured by directly observed frequency counts of target behaviors in an inpatient setting, was obtained.


CONCLUSIONS
Electroconvulsive therapy should be considered a potentially useful intervention in cases of children with autistic disorder and a severe comorbid affective disorder.
Spring Harbor Hospital, Westbrook, ME, USA. siegem@springharbor.org
Matthew
M
Siegel
Briana
B
Milligan
Douglas
D
Robbins
Glenn
G
Prentice
D000293:Adolescent; D000374:Aggression / Q000523:psychology; D018692:Antimanic Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001321:Autistic Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D001519:Behavior; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D016651:Lithium Carbonate / Q000627:therapeutic use; D008297:Male; D016728:Self-Injurious Behavior / Q000523:psychology
D018692:Antimanic Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D016651:Lithium Carbonate