Este estudo objetivou compreender os aspectos emocionais de crianças e adolescentes com diabetes tipo 1 (DM1) e seus familiares sob um olhar psicanalítico. Trata-se de um estudo qualitativo realizado por meio de entrevistas semiestruturadas com núcleos familiares de crianças e adolescentes com DM1. Os dados foram analisados de acordo com a análise de conteúdo, elegendo-se três categorias: diagnóstico, atendimento e tratamento. As crianças e adolescentes demonstraram sofrimento psíquico relacionado ao diagnóstico e internação hospitalar, com vivências de luto, sentimentos de desintegração e desproteção. Também denotaram sofrimento associado à restrição alimentar e aplicação da insulina. Continuidade do cuidado e disponibilidade dos membros da equipe interprofissional de saúde refletiram positivamente sobre o sentimento de segurança tanto dos familiares quanto das crianças e dos adolescentes. Na perspectiva da psicanálise, os aspectos emocionais observados nos núcleos familiares de crianças e adolescentes com DM1 afetaram sua condição de saúde, interferindo na aceitação, adesão e controle da doença.

A sixty three year old man was admitted for the first time in a psychiatry unit.The patient did not presented history of mental disorder before.He was hospitalized with an important level of anxiety. Could not feed himself, because there was a belief that his throat was “closed”, losing ten kilograms in a year. He thought his intestines and bladder were paralyzed.It was presented by him also ideas of being already dead (nihilistic delusions), insomnia, thoughts that all was ruined.Family reported also symptoms such as impulsiveness, mood lability, psychomotor agitation.He was diagnosed as having a bipolar depression. His treatment was initially based on neuroleptic drugs and mood stabilizers - lithium and olanzapine. As the patient responded poorly was tried the introduction of antidepressants. Firstly a tricyclic drug - amitriptyline then a selective inhibitor reuptake - paroxetine. Both drugs were uneffective.After several attempts with no resolutive medications ECT was tried.The patient was submitted to seven sessions of ECT and showed remarkably improvement.He was discharged after one month of hospitalization with presenting no more psychotic symptoms and keeping a stable mood.Although there are strong evidences in favor of the efficacy and safety of ECT this procedure is still surrounded by a lot of prejudice.This patient was accompanied by his son in all ECT sessions. When parents are able to watch the procedure it gives the patient more confidence and security. As a result the prognosis gets better and the stigma is defeated by comprehension.