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Successful Electroconvulsive Therapy in a Patient With Intellectual Disability and Bipolar Disorder, With Catatonic Features Misdiagnosed as Encephalopathy

Ligas, Adam MD; Petrides, Georgios MD; Istafanous, Rafik MD; Kellner, Charles H. MD

doi: 10.1097/YCT.0b013e3181911cfe
Case Reports

We describe the successful use of electroconvulsive therapy (ECT) in a 39-year-old woman with a complex clinical picture including bipolar disorder with catatonic features superimposed on a history of multiple congenital anomalies and intellectual and developmental disabilities. At age 34, the patient presented with marked regression and behavioral disturbance diagnosed as encephalopathy. Multiple medical evaluations were inconclusive, and treatment courses with antibiotics and steroids failed. After psychiatric evaluation, her condition was diagnosed as bipolar disorder with catatonic features. She was treated with ECT with dramatic improvement and resumption of her premorbid level of functioning. We discuss the relevant literature on the use of ECT in patients with intellectual disability.

From the UMDNJ-New Jersey Medical School, Newark, NJ.

Received for publication March 25, 2008; accepted October 10, 2008.

Reprints: Charles H. Kellner, MD, Department of Psychiatry, UMDNJ-New Jersey Medical School, Behavioral Health Sciences Bldg, F1436, 183 South Orange Ave, Newark, NJ 07101-1709 (e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.