Subject(s)
Depressive Disorder/diagnosis , Fatigue Syndrome, Chronic/diagnosis , Psychotic Disorders/diagnosis , Adult , Antipsychotic Agents/therapeutic use , Benzodiazepines/therapeutic use , Depressive Disorder/drug therapy , Depressive Disorder/therapy , Electroconvulsive Therapy , Emergency Services, Psychiatric , Fatigue Syndrome, Chronic/psychology , Female , Humans , Olanzapine , Psychotic Disorders/drug therapy , Psychotic Disorders/therapy , Suicidal Ideation , Treatment OutcomeSubject(s)
Forensic Psychiatry , Mental Health Services/organization & administration , Checklist , Forensic Psychiatry/legislation & jurisprudence , Forensic Psychiatry/methods , Forensic Psychiatry/organization & administration , Humans , Mental Health Services/legislation & jurisprudence , NorwayABSTRACT
Shortly after the birth of her first child a young woman became confused and agitated and was finally involuntarily admitted to an acute psychiatric ward. In spite of appropriate treatment with narcoleptics, she deteriorated from day to day and the staff members were uncertain what to do. New information from her close family concerning previous depressive and hippomanic episodes pointed to probable bipolar disorder. The treatment of choice was electroconvulsive therapy (ECT). In Norway this treatment requires informed consent, which she was not able to give. After consideration and discussions she was finally given ECT as emergency treatment. This had an immediate effect, and after a few treatments she recovered. She was given lithium to prevent relapse. At her 18 month follow-up visit she was stable and functioning well and had a good relationship with her child. Aspects of diagnostics and treatment as well as legal and ethical aspects are discussed.
