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Effectiveness of Electroconvulsive Therapy in a Patient With a Treatment-Resistant Major Depressive Episode and Comorbid Body Dysmorphic Disorder

Rapinesi, Chiara MD*†; Serata, Daniele MD*†; Del Casale, Antonio MD; Carbonetti, Paolo MD*; Fensore, Claudio MD*; Scatena, Paola MD*; Caccia, Federica MD; Di Pietro, Simone MD; Angeletti, Gloria MD; Tatarelli, Roberto MD; Kotzalidis, Georgios D. MD; Giradi, Paolo MD*†

doi: 10.1097/YCT.0b013e31827ce88e
Case Reports

A 24-year-old man experiencing comorbid body dysmorphic disorder since age 16 years, complicated in recent months by a major depressive episode with psychotic features, showed resistance to various drug and psychotherapy combinations. We suggested electroconvulsive therapy (ECT) to overcome treatment resistance. After 1 ECT cycle, mood and anxiety symptoms improved significantly, delusional interpretations and ideas of reference subsided, and dysmorphophobic symptoms improved as well. Six months later, the patient was doing well with a mood stabilizer/antipsychotic combination. Electroconvulsive therapy may improve symptoms of comorbid body dysmorphic disorder along with mood improvement in treatment-resistant depressive disorder.

From the *Department of Neuropsychiatry, Villa Rosa, Suore Ospedaliere of the Sacred Heart of Jesus, Viterbo; and †Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy.

Received for publication October 11, 2012; accepted November 6, 2012.

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

In the past 3 years, Paolo Girardi has received research support from Lilly, Otsuka, Janssen, and Springer Healthcare; has participated in Advisory Boards for Lilly, Organon, Pfizer, and Schering; and received honoraria from Lilly, Otsuka, Organon, and Springer Healthcare.

All other authors of this article 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. No writing assistance was used in the production of this article.

© 2013 by Lippincott Williams & Wilkins