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Successful and Rapid Response to Electroconvulsive Therapy of a Suicidal Patient With Comorbid Bipolar I Disorder and Histrionic Personality Disorder

Rapinesi, Chiara MD*†; Serata, Daniele MD*†; Del Casale, Antonio MD*; Simonetti, Alessio MD*; Milioni, Mara DPsych; Mazzarini, Lorenzo MD*†; Scatena, Paola MD*†; Fensore, Claudio MD; Carbonetti, Paolo MD; Kotzalidis, Giorgio D. MD*; Tatarelli, Roberto MD*; Pompili, Maurizio MD, PhD*‡; Girardi, Paolo MD*†

doi: 10.1097/YCT.0b013e3182218c8c
Brief Clinical Report Letters

A woman with bipolar disorder I, histrionic personality disorder, and suicidal ideation with repeated suicide attempts, who had been treated for 2 years with mood stabilizers, antipsychotics, and benzodiazepines, received a total of 8 bitemporal-biparietal electroconvulsive therapy sessions. Her suicidal ideation and self-harm behavior disappeared immediately after the first session and her psychopathology soon after. This supports the existence of a relatively independent suicidal syndrome and confirms data on its immediate responsiveness to electroconvulsive therapy. Electroconvulsive therapy must not be long withheld from patients with such characteristics to reduce unnecessary sufferance and suicidality.

From the *NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Saint Andrea Hospital, School of Medicine and Psychology, Sapienza University, Rome; †Department of Neuropsychiatry, Villa Rosa, Suore Hospitaliere of the Sacred Heart of Jesus, Viterbo, Italy; ‡McLean Hospital, Belmont and Harvard Medical School, Boston, MA.

Received for publication April 12, 2011; accepted April 26, 2011.

Reprints: Chiara Rapinesi, MD, NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Saint Andrea Hospital, School of Medicine and Psychology, Sapienza University, Via di Grottarossa 1035-1039, 00189 Rome, Italy (e-mail:

Paolo Girardi has, in the past 3 years, received research support from Lilly and Janssen; has participated in advisory boards for Lilly, Organon, Pfizer, and Schering; and has received honoraria from Lilly and Organon. Roberto Tatarelli has, in the past 3 years, participated in advisory boards for Schering, Servier, and Pfizer and received honoraria from Schering, Servier, and Pfizer. Giorgio D. Kotzalidis is recipient of the Italian Ministry of Health PhD grant for early interventions in psychoses.

All authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in, or financial conflict with, the subject matter or materials discussed in the article. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

© 2012 Lippincott Williams & Wilkins, Inc.