North American Journal of Medical Sciences

CASE REPORT
Year
: 2014  |  Volume : 6  |  Issue : 11  |  Page : 591--594

Rapid response of long-standing, treatment-resistant non-catatonic mutism in paranoid schizophrenia with single ECT session


Mansoor Ahmad Dar, Yasir Hassan Rather, Majid Shafi Shah, Rayees Ahmad Wani, Arshad Hussain 
 Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India

Correspondence Address:
Mansoor Ahmad Dar
Department of Psychiatry, Government Medical College, Srinagar - 190 003, Jammu and Kashmir
India

Context: Mutism is a common manifestation of catatonia, but mutism due to other forms of psychopathology and neurological disorders have also been described. Although not common, long-standing mutism has also been a feature of non-catatonic schizophrenia and traditionally responds less to conventional therapies. Case Report: We describe a rare case of paranoid schizophrenia presenting with continuous mutism for about 4 years. This 26-year-old male had symptoms of schizophrenia without catatonia. After failed trial of adequate pharmacotherapy and psychological intervention and considering his level of dysfunction, he was started on electroconvulsive therapy (ECT). To our surprise, he improved with a single session of ECT while he was on concurrent pharmacotherapy. We also discuss the possible explanation for this rapid effect of ECT in such clinical presentation. To our knowledge, this is the first case of non-catatonic mutism of schizophrenia of this long duration responding so promptly to ECT, although there are other reports as well in literature, but multiple ECT sessions were applied in those cases. Conclusion: Non-catatonic mutism is perhaps presenting as a cultural variant in this part of the world and whenever encountered, ECT should be an option. Further research should be carried out to validate this idea.


How to cite this article:
Dar MA, Rather YH, Shah MS, Wani RA, Hussain A. Rapid response of long-standing, treatment-resistant non-catatonic mutism in paranoid schizophrenia with single ECT session.North Am J Med Sci 2014;6:591-594


How to cite this URL:
Dar MA, Rather YH, Shah MS, Wani RA, Hussain A. Rapid response of long-standing, treatment-resistant non-catatonic mutism in paranoid schizophrenia with single ECT session. North Am J Med Sci [serial online] 2014 [cited 2022 May 17 ];6:591-594
Available from: https://www.najms.org/article.asp?issn=1947-2714;year=2014;volume=6;issue=11;spage=591;epage=594;aulast=Dar;type=0