2026-05-25T15:06:28Z https://www.peertechzpublications.org/oai-pmh

oai:www.peertechzpublications.org:10.17352/2455-5460.000021 2017-08-29 PTZ.ADA:VOL3

Hypochondriacal delusion in an elderly man with good response to electroconvulsive therapy but complicated with febrile reaction Mimi Mei Cheung Wong Pui-fai PangMichael Gar Chung Yiu<p style="text-align: justify;">In&nbsp; this&nbsp; case&nbsp; report,&nbsp; we&nbsp; present&nbsp; an&nbsp; elderly&nbsp; gentleman&nbsp; with&nbsp; prominent&nbsp; somatic&nbsp; delusions associated with&nbsp; depressive&nbsp; features.&nbsp; He&nbsp; was&nbsp; diagnosed&nbsp; to&nbsp; have&nbsp; severe&nbsp; depressive&nbsp; episode&nbsp; with&nbsp; mood&nbsp; congruent psychotic&nbsp;&nbsp; symptoms&nbsp;&nbsp; and&nbsp;&nbsp; was&nbsp;&nbsp; resistant&nbsp;&nbsp; to&nbsp;&nbsp; both pharmacological&nbsp;&nbsp; and&nbsp;&nbsp; psychological&nbsp;&nbsp; intervention.There&nbsp; was&nbsp; a&nbsp; differential&nbsp; diagnosis&nbsp; of&nbsp; delusional&nbsp; disorder,&nbsp; somatic&nbsp; subtype,&nbsp; resulting&nbsp; in&nbsp; a&nbsp; secondary depressive&nbsp; episode&nbsp; in&nbsp; view&nbsp; of&nbsp; his&nbsp; persistent&nbsp; somatic&nbsp; delusions&nbsp; which&nbsp; appeared&nbsp; more&nbsp; distressing&nbsp; and more prominent than his mood symptoms. Chronologically, his depressive symptoms had been there first, followed by more and more somatic complaints therefore he was concluded to have treatment resistant depression. Electroconvulsive therapy (ECT) was started with significant improvement especially for his hypochondriacal&nbsp; delusions.&nbsp; However,&nbsp; the&nbsp; ECT was&nbsp; complicated&nbsp; by&nbsp; recurrent&nbsp; febrile&nbsp; reaction&nbsp; which&nbsp; had close temporal relationship with each ECT session but was noted to be benign in nature. This patient has reminded us that psychotic depression is common in the elderly and may have atypical presentation. ECT is&nbsp; an&nbsp; effective&nbsp; treatment&nbsp; option&nbsp; for&nbsp; those&nbsp; resistant&nbsp; to&nbsp; pharmacological&nbsp; and&nbsp; psychological&nbsp; intervention. It has resulted in a fast and complete recovery for hypochondriacal delusion. Febrile reactions might be associated with ECT and it is important to rule out other causes.</p> Archives of Depression and Anxiety - Peertechz Publications 2017-08-29 Case Report https://doi.org/10.17352/2455-5460.000021 en Copyright © Mimi Mei Cheung Wong et al.