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Electroconvulsive Therapy Studies · Journal article
Cureus · August 9, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a single case report of a 62-year-old woman with treatment-resistant psychosis and schizophrenia who refused ECT despite clinical deterioration and family advocacy for the procedure. The case illustrates ethical and clinical tensions in capacity assessment and surrogate decision-making but provides no quantitative outcome data, efficacy comparison, or evidence on the treatment question itself.
Single case report. A 62-year-old woman with longstanding paranoid schizophrenia, general anxiety disorder, hypertension, and hyperlipidemia, admitted for acute psychosis following medication nonadherence and recent maternal death.. Intervention: ECT was considered but refused by the patient; pharmacotherapy with haloperidol, lorazepam, and lurasidone was administered.. n = 1.
Patient with longstanding paranoid schizophrenia, general anxiety disorder, hypertension, and hyperlipidemia presented with acute psychosis following medication nonadherence Patient demonstrated limited improvement with pharmacotherapy alone (haloperidol, lorazepam, lurasidone) and remained unable to maintain activities of daily living Family reported prior improvement with past ECT sessions but patient refused treatment during current admission
No data on ECT efficacy, safety, or outcome in this case; treatment was refused and not administered. Patient demonstrated limited improvement with pharmacotherapy alone (haloperidol, lorazepam, lurasidone) and remained unable to maintain activities of daily living
This case presents clinical and ethical dilemmas rather than evidence to guide treatment; it highlights the need for capacity assessment and shared decision-making frameworks but does not provide quantitative outcome data to inform ECT use in similar patients.
A single uncontrolled case report describing clinical and ethical decision-making in one patient; no comparative data, outcome measurements, or generalizable evidence on treatment efficacy.
As stated by the source record.
Quoted from the source exactly as published.
This case presents clinical and ethical dilemmas rather than evidence to guide treatment; it highlights the need for capacity assessment and shared decision-making frameworks but does not provide quantitative outcome data to inform ECT use in similar patients.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Electroconvulsive therapy (ECT) remains among the most effective interventions in psychiatry for severe depression, catatonia, and treatment-resistant psychosis. Despite its well-established efficacy and safety profile, particularly in medically complex and older patients, its use continues to evoke controversy due to the required medical clearance. Ethical dilemmas arise when patients lack insight or capacity to consent, creating tension between respect for autonomy and the duty of beneficence. We present the case of a 62-year-old woman with a longstanding history of paranoid schizophrenia, general anxiety disorder, hypertension, and hyperlipidemia who was admitted for acute psychosis following medication nonadherence and the recent death of her mother. Her presentation was notable for bizarre delusions, a disorganized thought process, and poor self-care. She was partially compliant with psychotropic therapy, including haloperidol, lorazepam, and lurasidone, but demonstrated limited improvement. Although ECT was considered given the severity and chronicity of her illness, the patient refused treatment. Her family emphasized the gradual deterioration they had observed and advocated strongly for pursuing ECT as the necessary intervention to prevent further decline, given her improvement with past ECT sessions. Over the course of hospitalization, her symptoms improved only mildly with pharmacotherapy alone, and she remained unable to maintain activities of daily living. This case highlights the enduring clinical and ethical complexities surrounding the use of ECT. It underscores the importance of evaluating capacity, engaging families in shared decision-making, and balancing the principles of autonomy and beneficence in the treatment of severe psychiatric illness.
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