ABSTRACT
OBJECTIVE: To explore some of the emerging complexities in the management of childhood gender dysphoria. CONCLUSION: The authors raise questions about the gender-affirmation approach and highlight concerns about informed consent and research ethics.
Subject(s)
Gender Dysphoria/diagnosis , Gender Dysphoria/therapy , Informed Consent , Psychiatry/ethics , Sex Reassignment Procedures/ethics , Australia , Child , Humans , Societies, MedicalABSTRACT
OBJECTIVES: To describe and discuss the use of maintenance electroconvulsive therapy (ECT) in a young woman with Down syndrome and depression with catatonia. METHODS: Clinical case report. RESULTS: A 23-year-old woman with Down syndrome (mosaic type) and a 4-year history of depressed mood triggered by adverse life events presented with mutism, psychomotor retardation, and compromised oral intake. Multiple trials of antidepressant medications were either ineffective or complicated by adverse reactions. She improved rapidly with a course of bilateral ECT but required maintenance ECT to sustain recovery. A series of premorbid, morbid, and post-treatment drawings by the young woman highlight the efficacy of treatment. CONCLUSION: Electroconvulsive therapy was found to be a safe and effective treatment for life-threatening mental illness in a young woman with Down syndrome who had failed multiple trials of antidepressant medications. This case highlights the importance of considering catatonia as a diagnosis in persons with Down syndrome and the effectiveness of electroconvulsive treatment.
