Successful Resolution of Messianic Delusion following Bi-temporal Modified Electroconvulsive Therapy in a Patient with Treatment-resistant Schizophrenia
Published: March 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/65271.19167
Aakanksha Kharb, Sunny Garg, Priti Singh
1. Senior Resident, Department of Psychiatry, B.P.S. Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India.
2. Assistant Professor, Department of Psychiatry, B.P.S. Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India.
3. Senior Professor, Department of Psychiatry, Institute of Mental Health, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India.
Correspondence
Aakanksha Kharb,
Senior Resident, Department of Psychiatry, B.P.S. Government Medical College for Women, Khanpur Kalan, Sonipat-131305, Haryana, India.
E-mail: aakanksha151kharb@gmail.com
Messianic delusion comprises a delusional system centered on the patient’s conviction that he has been selected by God for a special task or mission and has unique abilities to carry it out. The present case report describes a case of Treatment-Resistant Schizophrenia (TRS) with Messianic delusion in a 23-year-old unmarried male who presented to the Emergency Department with complaints of muttering to himself, decreased sleep, suspiciousness, socio-occupational dysfunction, aggressive behaviour, and a recent suicide attempt. Key interventions offered during the ward stay included rapid tranquilisation, antipsychotics, and benzodiazepines. The patient completely recovered with the concurrent use of clozapine and Modified Electroconvulsive Therapy (MECT). The patient received 16 sessions of MECT. He achieved both short-term and long-term remission with the therapy, as observed during regular follow-ups in the next six months. The present case emphasises the need for a multidisciplinary approach to the management, early detection, and adequate treatment of this challenging illness.
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