30th January 2024

Lucy is a 33-year-old female who suffers from severe depression and Emotionally Unstable Personality Disorder (EUPD)

Lucy is a 33-year-old female who suffers from severe depression and Emotionally Unstable Personality Disorder (EUPD).

On examination, she is soft-spoken, withdrawn, thin, and her clothes are visibly stained. She seems to be reacting to unseen stimuli. Her sister says that she does not think Lucy has cleaned her house, gone outside, or purchased groceries in days.

She refuses your offer of antidepressants, stating she would rather die than take tablets, which she has been averse to doing since adolescence. She has no other past medical history, and this is her first mood episode.

Which of the following features of her presentation provides the best rationale for offering ECT?

Select the SINGLE most appropriate option from the list below. Select ONE option only.