Psychotic major depressive disorder and REM sleep behavior disorder co-occurring with pineal cyst: adolescent case report with neuroimaging analysis

A 15-year-old girl with severe depression, psychotic features, and suicidal behavior was found to have a pineal cyst and rapid eye movement sleep behavior disorder on diagnostic evaluation. Treatment with adjusted psychiatric medications, electroconvulsive therapy, and psychotherapy resulted in significant clinical improvement across mood, psychotic, and sleep symptoms.