DOI: 10.1373/clinchem.2011.176925


A 58-year-old woman in the depressive phase of bipolar disorder (BPD)3 type 1 enrolled in a clinical study of the efficacy of a new form of electroconvulsive therapy (ECT) for her depression, because ECT has not been commonly used for the treatment for BPD or depression. BPD is any of several mood disorders characterized by alternating episodes of depression and mania or by episodes of depression alternating with mild nonpsychotic excitement. BPD type 1 is distinguished from type 2 according to the severity of increased mood symptoms (1). At study enrollment, the patient reported severe sadness, a lack of motivation, fatigue, general malaise, feelings of guilt, and an increased need for sleep, but she had no suicidal or homicidal thoughts.