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After psychiatric treatment and neurosurgical operation, rapidly ameliorated clinical symptoms in a patient who had severe depression with catatonic features is discussed in this paper. A 64 years old male has had symptoms, which were appetite, alogia, anhedonia, decreased self care and incontinence for two months. After medical assessment, it had been said that there was no organic illness and he had been referred to psychiatry. After psychiatric assessment, he has not taken his medications regularly and complaints with urinary and fecal incontinence continued and he was admitted to emergency service and thereafter hospitalization was completed. In his psychiatric examination, self-care was decreased, psychomotor activity was decreased, he was alogic, only his eye movements were observed communicative. Conscious state was clear, he was cooperating. Affect and mood were depressed. He was insensitive time to time. HAM-D and Mini mental state scale scores were 34 and 16 , respectively. ECT was planned after internal medicine and anesthesia consultation and venlafaxine 75 mg/day and quetiapine 50 mg/day treatment was started. After neurological consultation in which cranial MRI was carried out, a colloidal cyst was detected in third ventricule. Neurosurgical consultation was made thereafter. His symptoms except urinary and fecal incontinence has gone better with psychiatric treatment and he was expedited to neurosurgery for operation. Two weeks after cystectomy, he was seen in outpatient clinic. A clear-cut improvement was there in his symptoms as he was taking own medications by himself and caring himself. Cyst-like compositions in brain might exaggerate psychiatric scene in psychiatric disorders. In this case, after neurosurgery, the complaints of urinary and fecal incontinence were ameliorating in the patient, who had progressive severe depression with catatonic features. In psychiatric disorders, regardless of pathological compositions in brain, the importance of cranial scanning was stressed in this case.