{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T14:00:56Z","timestamp":1781704856470,"version":"3.54.5"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Treatment options for severe self-injurious behavior (SIB) in autism spectrum disorder (ASD) with comorbid intellectual disability (ID) are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 24-year-old man with ASD and severe ID presented with treatment-refractory SIB (an 11-year history; baseline frequency of 5\u20136 hand-biting episodes per day during pre-modified electroconvulsive therapy (MECT) hospitalization observation), despite multiple pharmacotherapy trials. On Day 27, baseline assessments and pre-MECT demonstrated a Violence Risk Assessment Scale (VRAS) score of 18, a Brief Psychiatric Rating Scale (BPRS) score of 74, an Activities of Daily Living (ADL) score of 46, and 4\u20135 h of nocturnal sleep each night. After 12 sessions of MECT administered over 7 weeks, the primary outcome, that is, SIB frequency, completely resolved (no hand-biting episodes each day). Additionally, secondary outcome measures showed marked improvement, including a VRAS score of 7 (a 61.1% reduction), a BPRS score of 47 (a 36.5% reduction), an ADL score of 34 (a 26.1% improvement in functional independence), and 5\u20136 h of nocturnal sleep each night. At 30 days post-MECT (Day 106, during continued hospitalization), therapeutic gains were sustained and further enhanced: the VRAS score persisted at 7, the BPRS score decreased to 35 (a 52.7% reduction from baseline), and the ADL score improved to 30 (a 34.8% improvement in functional independence from baseline), with complete resolution of SIB (self-directed harmful acts) and aggressive behavior (other-directed harmful acts). The patient scored zero on the VRAS. No serious adverse events were observed during hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Based on controlled nursing frequency counts, mental assessment scales, and photographic wound records, this case provides preliminary observational evidence that MECT may reduce treatment-refractory SIB in patients with ASD and severe ID. Further controlled studies using standardized SIB outcome measures are warranted, given the lack of validated SIB-specific instruments and the limitations inherent to a single-case design.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1800695","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T13:49:49Z","timestamp":1781704189000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Modified electroconvulsive therapy for treatment-resistant self-injurious behavior in autism spectrum disorder with severe intellectual disability: a case report"],"prefix":"10.3389","volume":"17","author":[{"given":"Ping","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Nanjing Lishui District Psychiatric Hospital","place":["Lishui, China"]},{"name":"Department of Psychiatry, The Third People\u2019s Hospital of Lishui District","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didi","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Nanjing Lishui District Psychiatric Hospital","place":["Lishui, China"]},{"name":"Department of Psychiatry, The Third People\u2019s Hospital of Lishui District","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuehua","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Nanjing Lishui District Psychiatric Hospital","place":["Lishui, China"]},{"name":"Department of Psychiatry, The Third People\u2019s Hospital of Lishui District","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Nanjing Meishan Hospital","place":["Nanjing, China"]},{"name":"Department of Psychiatry, Medical College of Soochow University","place":["Suzhou, China"]},{"name":"Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"B1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders, 5th Ed. 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