27th National Clinical Education Symposium Presentation Abstracts

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Ayça Nur Örün, Şuheda Tapan Çelikkaleli

29 APRIL 2025, MONDAY
13:00-14:00 POSTER PRESENTATION SESSION-2

Association With Personality Patterns Of Patients With Early-Onset Resilient Mood Disorder And Benefit From ECT

Duçem Selena İşmar1, Alpaslan Girgin1, Güneş Devrim Kıcalı1

1. Muğla Sıtkı Koçman University Department of Mental Health and Diseases

DOI: 10.5080/kes27.abs130 Page 156
OBJECTIVE:Bipolar disorder and related conditions are among the most common psychological disorders worldwide, with typical onset during early adulthood. Triggers include stressful life events, obstetric complications, physical illnesses, and substance use. Treatment involves mood stabilizers, benzodiazepines, antipsychotics, antidepressants, and electroconvulsive therapy (ECT). This report presents a case of early-onset bipolar disorder exacerbated by stress caused by the patient’s mother’s chronic illness and multiple suicide attempts. CASE (The patient consent must be provided and specified with appropriate terms.):A 19-year-old woman had attempted suicide multiple times since the age of 15. Despite treatment with various mood stabilizers, antipsychotics, and antidepressants in multiple hospitals, her symptoms persisted. Her mood disorder worsened due to the stress related to her mother’s illness. Previous child psychiatry evaluations indicated impulsive suicidal behaviors, unstable relationships, intense anger, and emotional dysregulation, suggesting borderline personality traits. While staying in a nursing home, she impulsively broke a window with the intent of suicide. She reported auditory hallucinations stating that everything would go wrong. A mental state examination revealed self-harm marks, dysphoric mood, fluctuating emotions, and passive suicidal thoughts. She was using Lithium, Lamotrigine, Aripiprazole, Olanzapine, Haloperidol, Biperiden, and Quetiapine. Due to the persistence of symptoms, depot antipsychotics (Zuclopenthixol, Paliperidone) and ECT were administered. After ECT, her mood stabilized, and suicidal thoughts decreased. Her Young Mania Score decreased from 35 to 10. ECT was performed using the Thymatron device, starting at 35% energy and increasing by 5% each time, completing 12 sessions and finishing at 90% energy. An EEG showed 25 seconds of effective electrophysiological activity. 10 out of 12 sessions were effective. Written consent was obtained from the patient. DISCUSSION:This case emphasizes the interaction between bipolar disorder and borderline personality traits, and how stress caused by the mother’s chronic illness exacerbated the condition. ECT provided a dramatic response.