Electroconvulsive therapy for trunk and visceral cenesthopathy associated with major depressive disorder: A case series of three elderly women

Abstract Background Severe cenesthopathy associated with major depressive disorder (MDD) may cause malnutrition and functional decline. We report three elderly women with trunk and visceral cenesthopathy associated with MDD who improved markedly following electroconvulsive therapy (ECT). Case Presentation Case A: A woman in her 60s developed MDD while caring for her mother with dementia. Despite pharmacological treatment, trunk, limb, and oral cenesthopathy developed 6 months later, resulting in reduced food intake and physical deterioration. Symptoms improved after six ECT sessions, nearly resolved after 12, and ECT was completed after 15 sessions without recurrence. Case B: A woman in her 70s developed MDD after prolonged caregiving stress. Despite pharmacological treatment, she developed trunk and visceral cenesthopathy with organ displacement sensations, dyspnea, speech disturbance, and loss of appetite. Cenesthopathy resolved after three ECT sessions; dyspnea and speech disturbance improved after 10. ECT was completed after 13 sessions. After recurrence, a second acute ECT course followed by maintenance ECT maintained clinical stability. Case C: A woman in her 70s with longstanding MDD developed visceral and oral cenesthopathy after discontinuing antidepressants. Despite pharmacological treatment, she became unable to eat or drink. Cenesthopathy resolved after four ECT sessions, restoring oral intake. ECT was completed after eight sessions without recurrence. Conclusion ECT may be an effective treatment for trunk and visceral cenesthopathy associated with MDD. Early consideration of ECT may be warranted when malnutrition or physical deterioration necessitates rapid symptom control.