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A Case of Treatment- resistant Depression and Body Dysmorphic Disorder: The Role of Electroconvulsive Therapy Revisited

机译:一例具有抗药性的抑郁症和身体畸形障碍:重新探讨电惊厥治疗的作用

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摘要

Body dysmorphic disorder is a common, often disabling condition, and is frequently comorbid with major depressive disorder. Selective serotonin reuptake inhibitors constitute first line set of somatic interventions but the management of refractory patients remains challenging. Electroconvulsive therapy, an often highly beneficial treatment for medication resistant-depression, is not considered an effective therapeutic alternative for treatment refractory body dysmorphic disorder. Here we present a 50-year-old woman with body dysmorphic disorder and comorbid major depressive disorder who remained incapacitated and suicidal despite several trials with selective serotonin reuptake inhibitors and antipsychotic medication. Depressive and dysmorphic symptoms appeared to resolve with electroconvulsive therapy, and remission was sustained for two months. Electroconvulsive therapy has an important place in the management of treatment- resistant depression associated with body dysmorphic disorder, and, in select cases, may be effective for dysmorphic symptoms as well.
机译:身体变形障碍是一种常见的,常常是致残的疾病,并经常与重度抑郁症并存。选择性5-羟色胺再摄取抑制剂构成了躯体干预的第一线手段,但难治性患者的治疗仍然具有挑战性。电痉挛疗法通常是治疗药物抵抗性抑郁症的高度有益的疗法,但并未被认为是治疗难治性身体畸形病症的有效替代疗法。在这里,我们介绍了一名50岁的女性,患有身体变形障碍和合并症的重度抑郁症,尽管经过多次选择性5-羟色胺再摄取抑制剂和抗精神病药物的试验,但仍无行为能力和自杀性。抑郁和畸形症状似乎在电抽搐治疗后得以缓解,缓解持续了两个月。电惊厥疗法在治疗与身体畸形症相关的抵抗力抑郁症方面具有重要地位,并且在某些情况下,对于畸形症状也可能有效。

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