P-1380 - Fighting against stigma in ECT- when family is allowed to watch the procedure a case report

Abstract

A sixty three year old man was admitted for the first time in a psychiatry unit.The patient did not presented history of mental disorder before.He was hospitalized with an important level of anxiety. Could not feed himself, because there was a belief that his throat was “closed”, losing ten kilograms in a year. He thought his intestines and bladder were paralyzed.It was presented by him also ideas of being already dead (nihilistic delusions), insomnia, thoughts that all was ruined.Family reported also symptoms such as impulsiveness, mood lability, psychomotor agitation.He was diagnosed as having a bipolar depression. His treatment was initially based on neuroleptic drugs and mood stabilizers - lithium and olanzapine. As the patient responded poorly was tried the introduction of antidepressants. Firstly a tricyclic drug - amitriptyline then a selective inhibitor reuptake - paroxetine. Both drugs were uneffective.After several attempts with no resolutive medications ECT was tried.The patient was submitted to seven sessions of ECT and showed remarkably improvement.He was discharged after one month of hospitalization with presenting no more psychotic symptoms and keeping a stable mood.Although there are strong evidences in favor of the efficacy and safety of ECT this procedure is still surrounded by a lot of prejudice.This patient was accompanied by his son in all ECT sessions. When parents are able to watch the procedure it gives the patient more confidence and security. As a result the prognosis gets better and the stigma is defeated by comprehension.