Mahato Ram S, San Gabriel Maria Chona P, Longshore Carrol T, Schnur David B
The authors are with the Department of Psychiatry at Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, Elmhurst, New York.
Innov Clin Neurosci. 2016 Aug 1;13(7-8):37-40. eCollection 2016 Jul-Aug.
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.
躯体变形障碍是一种常见且往往导致功能障碍的疾病，常与重度抑郁症共病。选择性5-羟色胺再摄取抑制剂是躯体干预的一线用药，但难治性患者的管理仍然具有挑战性。电休克治疗对药物抵抗性抑郁症通常是一种非常有效的治疗方法，但它不被认为是治疗难治性躯体变形障碍的有效替代疗法。在此，我们报告一名50岁患有躯体变形障碍和共病重度抑郁症的女性，尽管多次尝试使用选择性5-羟色胺再摄取抑制剂和抗精神病药物治疗，她仍丧失行为能力并存在自杀倾向。电休克治疗后抑郁和变形症状似乎得到缓解，且缓解持续了两个月。电休克治疗在伴有躯体变形障碍的难治性抑郁症管理中具有重要地位，并且在某些情况下，对变形症状可能也有效。
