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Something inside my head

Published online by Cambridge University Press:  01 September 2022

T. Jiménez Aparicio*
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
G. Medina Ojeda
Affiliation:
Sacyl, Hospital Clínico Universitario Valladolid, Psiquiatría, Valladolid, Spain
C. De Andrés Lobo
Affiliation:
Hospital Clínico Universitario de Valladolid, Psiquiatría, VALLADOLID, Spain
C. Vallecillo Adame
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
J. Gonçalves Cerejeira
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
I. Santos Carrasco
Affiliation:
Clinical Hospital of Valladolid, Psychiatry, Valladolid, Spain
G. Guerra Valera
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
A. Gonzaga Ramírez
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
M. Queipo De Llano De La Viuda
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
N. Navarro Barriga
Affiliation:
Hospital Clínico Universitario de Valladolid, Psiquiatría, VALLADOLID, Spain
M. Fernández Lozano
Affiliation:
Hospital Clínico Universitario de Valladolid, Psiquiatría, VALLADOLID, Spain
B. Rodríguez Rodríguez
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
M.J. Mateos Sexmero
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
N. De Uribe Viloria
Affiliation:
Hospital Universitario Fundación de Alcorcón, Psiquiatría, Valladolid, Spain
*
*Corresponding author.

Abstract

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Introduction

Electroconvulsive therapy (ECT) is a medical treatment for those patients with high suicide risk or refractory psychiatric disorders. It is currently a safe technique, and its effectiveness has been widely demonstrated.

Objectives

Presentation of a clinical case about a patient with drug-resistant delusional disorder and high suicide risk, who eventually received ECT treatment.

Methods

Bibliographic review including the latest articles in Pubmed about ECT procedure, effects and use.

Results

We present a 45-year-old man, who visited different doctors several times by reporting he had the feeling of “having a brain tumor or a vascular disorder”, so he requested imaging tests (computed tomography and magnetic resonance). These tests were absolutely normal, but he kept thinking something was wrong, and eventually attempted suicide by hanging (his family founded him before it was too late). The patient was admitted to hospital, and started psychopharmacological treatment, with minimal response. He desperately insisted that he had “something inside his head”. At this point, it was proposed to start ECT, and the patient accepted. After 6 bilateral ECT sessions, he was visibly more relaxed and less worried, and he no longer presented autolytic ideation. He was still a little bit suspicious about the feeling of having a neurological disease. Currently, the patient runs a follow-up consultation.

Conclusions

Electroconvulsive therapy is a safe and effective technique for those patients with high suicide risk. It may be useful to perform imaging tests in certain cases, for detecting intracranial pressure, acute hemorrhage, tumors… A follow-up of these patients must be performed

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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