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Electroconvulsive therapy for manic state with mixed and psychotic features in a teenager with bipolar disorder and comorbid episodic obsessive–compulsive disorder: a case report

Overview of attention for article published in Journal of Medical Case Reports, December 2017
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (55th percentile)
  • High Attention Score compared to outputs of the same age and source (84th percentile)

Mentioned by

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2 tweeters
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1 Facebook page
reddit
1 Redditor

Citations

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6 Dimensions

Readers on

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102 Mendeley
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Title
Electroconvulsive therapy for manic state with mixed and psychotic features in a teenager with bipolar disorder and comorbid episodic obsessive–compulsive disorder: a case report
Published in
Journal of Medical Case Reports, December 2017
DOI 10.1186/s13256-017-1508-8
Pubmed ID
Authors

Olof Rask, Klara Suneson, Eva Holmström, Beata Bäckström, Björn Axel Johansson

Abstract

Comorbidity of bipolar disorder and obsessive-compulsive disorder is common in adolescence. Obsessive-compulsive disorder symptoms may be episodic and secondary to alterations in mood, and display specific features. Management of pediatric bipolar disorder-obsessive-compulsive disorder is challenging, as pharmacotherapy of obsessive-compulsive disorder may induce or exacerbate manic episodes and there is limited evidence of treatment efficacy. Electroconvulsive therapy is sparsely used in children and adolescents, but is documented to be a safe and efficacious intervention in adults with bipolar disorder. In view of the severity of symptoms in juvenile mania, studies on treatment strategies are warranted. We report a case of an adolescent with bipolar disorder-obsessive-compulsive disorder who was successfully treated with electroconvulsive therapy during an episode of severe mania. A 16-year-old girl of Middle East origin first presented to us with depressed mood, irritability, and increased obsessive-compulsive disorder symptoms, which were initially interpreted in the context of acute stress secondary to migration. She had been diagnosed with bipolar disorder and obsessive-compulsive disorder in her previous home country, but had difficulties in accounting for earlier psychiatric history. During hospitalization her mood switched to a manic state with mixed and psychotic features, at times showing aggression toward others. Interruption in her lithium treatment for a short period and possibly the introduction of an atypical antipsychotic could in part have been triggering factors. After 8 weeks of in-patient care and psychotropic drug trials, electroconvulsive therapy was initiated and administered every second or third day for 4 weeks, with marked positive response. No apparent side effects were reported. This case demonstrates the need for a detailed medical history, taking special note of periodicity and character of obsessive-compulsive disorder symptoms, in adolescents with mood disorders. When treating culturally diverse patients, extra consideration should be taken. Special concerns in the pharmacological treatment to avoid the patient's condition from worsening must be addressed, including giving priority to mood stabilization before obsessive-compulsive disorder symptoms. There are potential benefits in considering electroconvulsive therapy in young patients with severe mania where first-line treatment options have failed.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 102 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 102 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 15 15%
Student > Bachelor 12 12%
Other 10 10%
Student > Master 10 10%
Student > Doctoral Student 8 8%
Other 16 16%
Unknown 31 30%
Readers by discipline Count As %
Medicine and Dentistry 21 21%
Psychology 14 14%
Nursing and Health Professions 6 6%
Neuroscience 6 6%
Social Sciences 4 4%
Other 14 14%
Unknown 37 36%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 March 2018.
All research outputs
#7,436,036
of 13,785,324 outputs
Outputs from Journal of Medical Case Reports
#487
of 2,366 outputs
Outputs of similar age
#168,289
of 393,733 outputs
Outputs of similar age from Journal of Medical Case Reports
#41
of 303 outputs
Altmetric has tracked 13,785,324 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,366 research outputs from this source. They receive a mean Attention Score of 3.2. This one has done well, scoring higher than 77% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 393,733 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.
We're also able to compare this research output to 303 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 84% of its contemporaries.