title: Life-saving electroconvulsive therapy in a patient with near-lethal catatonia.
abstract: A young woman with bipolar I disorder and comorbid catatonia on enteral nutrition from several months, developed a form of near-lethal catatonia with weight loss, pressure sores, muscle atrophy, electrolyte imbalance, and depression of vital signs. A compulsory treatment was necessary, and informed consent was obtained from her mother for electroconvulsive therapy (ECT). After 7 ECT sessions, the patient recovered and resumed feeding. ECT may save the life of a patient with catatonia provided that legal obstacles are overcome. Clinicians should carefully evaluate patients with near-lethal catatonia, taking into account the risk of pulmonary embolism and other fatal events. The medical-legal issues, which vary across state regulations, should be addressed in detail to avoid unnecessary and potentially harmful delay in intervention.
authors.affiliation: Department of Neuropsychiatry, Villa Rosa, Suore Hospitaliere of the Sacred Heart of Jesus, Viterbo, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
authors.forename: Chiara
authors.initials: C
authors.lastname: Rapinesi
authors.forename: Ilaria
authors.initials: I
authors.lastname: Cuomo
authors.forename: Giorgio D
authors.initials: GD
authors.lastname: Kotzalidis
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Casale
authors.forename: Daniele
authors.initials: D
authors.lastname: Serata
authors.forename: Sandra
authors.initials: S
authors.lastname: Campi
authors.forename: Matteo
authors.initials: M
authors.lastname: Caloro
authors.forename: Lavinia
authors.initials: L
authors.lastname: De Chiara
authors.forename: Stefano Maria
authors.initials: SM
authors.lastname: Tamorri
authors.forename: Paola
authors.initials: P
authors.lastname: Scatena
authors.forename: Federica
authors.initials: F
authors.lastname: Caccia
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Bersani
authors.forename: Paolo
authors.initials: P
authors.lastname: Carbonetti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vento
authors.forename: Giorgia
authors.initials: G
authors.lastname: Dimitri-Valente
authors.forename: Roberto
authors.initials: R
authors.lastname: Tatarelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Fensore
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferracuti
authors.forename: Gloria
authors.initials: G
authors.lastname: Angeletti
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D002389:Catatonia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D033282:Parental Consent; D016896:Treatment Outcome