Use of Electroconvulsive Therapy in an Adolescent Patient with Catatonia

Catatonia was first described by Kahlbaum [1] in 1874, as a brain disorder, which has cyclic, alternating and progressive course.Over the years, understanding about catatonia has increased and it is now well-known that besides the primar y psychiatric disorders, catatonia is associated with many neurological and medical disorders.[2] Catatonia in adolescents has been reported to be associated with affective, psychotic, autistic, developmental, drug induced and medical conditions.[3] Evidence suggests that the symptom profile of catatonia in adolescents is similar to adults.Further, as in adults, catatonia in children and adolescents also responds to benzodiazepines and electroconvulsive therapy (ECT).However, the literature on the use of ECT in adolescents with catatonia is limited.In this case report, we present a case of catatonic schizophrenia, treated with ECT and review the literature on the use of ECT in adolescent catatonia. CASE REPORTA 16-year-old single girl presented with an insidious onset illness of 3 year duration.For the initial 1 year, the symptoms were characterized by fearfulness, anxiety, derealization and poor academic performance.During the 2 nd and 3 rd years of symptomatic phase, she developed additional symptoms of social withdrawal, poor initiative, irritability, muttering and gesturing in air, suspiciousness, delusions of reference and persecution and delusion of misidentification, poor self-care and stopped studying.About a month prior to presentation to our center, her speech output started reducing, she had perseveration and later became mute, had marked psychomotor retardation, ambitendency, active and passive negativism, posturing and refusal to eat.She was taken to a psychiatrist for her symptoms and was given intravenous lorazepam up to 8 mg/day along with risperidone up to 4 mg/day, but did not show any improvement.Following this, consultation