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Intractable depression or psychosis
1Department of Psychiatry and Neurology, College of Community Health Science, University of Alabama School of Medicine, Tuscaloosa, AL 35487-0326, USA.
Objective:
Some patients with treatment resistant depression may have a difficult to recognize and therefore untreated thought disorder. Even a subtle disorder may significantly impact patients' lives. This case illustrates a mechanism for identifying and treating this subgroup of patients.
Method:
The treatment of a 67-year-old female with intractable depression is described.
Results:
The Rorschach Exner Comprehensive System identified the presence of a thought disorder with four out of five conditions positive on the Schizophrenia Index and five out of seven conditions positive on the Depression Index. Low-dose risperidone was added to the patient's medications with excellent results. Post-testing indicated that the Schizophrenia and Depression Indices were no longer positive.
Conclusion:
A subgroup of patients with intractable depression may have an underlying thought disorder that can be identified with the Rorschach and successfully treated with low-dose antipsychotic medication.