Combination of electroconvulsive therapy with skin graft surgery for a schizophrenic patient with burns.

We report on the use of electroconvulsive therapy (ECT) on a patient with schizophrenia immediately after skin graft surgery for extensive burns. The patient was 22 years old and had been burned in more than 33% of his body because of a suicide attempt. After his admission to a burn unit, he continued to make repeated suicide attempts. Electroconvulsive therapy with a muscle relaxant and intubation was administered after scheduled skin graft surgery. His hallucinations diminished after a series of ECT treatments, and his behavior improved. This combination avoids an anesthetic procedure and makes it possible for physicians to administer ECT earlier for burned psychopharmacological treatment-resistant psychiatric patients. The combination treats a patient's physical and mental illnesses simultaneously.