The role of electroconvulsive therapy (ECT) in the treatment of a life-threatening condition in a patient with paranoid schizophrenia a case report in the context of limited availability of therapy in Poland
DOI:
https://doi.org/10.12923/2353-8627/2025-0018Keywords:
schizophrenia, electroconvulsive therapy, convulsive therapyAbstract
Introduction: Schizophrenia represents a leading cause of acute psychotic episodes and is frequently associated with profound social dysfunction and in severe cases, it may result in conditions posing an immediate threat to life. Management typically involves biological treatment modalities combined with psychotherapy; however, a subset of patients develops treatment resistance. Electroconvulsive therapy (ECT) remains a key intervention for overcoming pharmacoresistance, despite its limited availability in Poland.
Material and method: The article present a clinical case report and a literature review based on the MEDLINE database.
Results: The case study concerns a 20-year-old woman who developed a severe, prolonged psychotic state as a consequence of treatment refusal. Owing to the critical clinical condition, confirmed pharmacoresistance and progressive secondary malnutrition, ECT was initiated as a life-saving measure under the principle of medical necessity. A marked improvement in mental status was observed after the first session. Upon completion of the full ECT course, the patient was discharged home in logical contact, without psychotic symptoms, with a diagnosis of paranoid schizophrenia.
Conclusions: The case supports the conclusion that ECT is an effective method for overcoming pharmacoresistance in acute psychosis and may constitute one of the most efficacious therapeutic options. In certain situations, the benefits of ECT outweigh those of pharmacotherapy alone. This case is of particular clinical relevance as it illustrates a life-saving application of ECT. The literature review further confirms the efficacy and safety of this treatment modality. Nevertheless, access to ECT in Poland remains insufficient and excessive ancillary procedural requirements reduce its cost-effectiveness, contributing to the persistence of this limitation.
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Copyright (c) 2025 Patrycja Najda, Oliwia Rdzanek, Emilia Kamizela, Janusz Sauermann, Sylwiusz Niedobylski, Michał Próchnicki (Autor)
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