Foulon C
Service du Professeur Guelfi, Hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris.
Encephale. 2003 Sep-Oct;29(5):463-6.
The comorbidity of schizophrenia and eating disorders is understudied. In the early nineteenth century, Eugen Bleuler has reported cases of schizophrenia with eating disorders that were related to delusional ideas. Potomania, merycism and pica have often been described in schizophrenic patients. Schizophrenic patients with eating disorders usually do not meet all criteria for typical eating disorders and are therefore classified as "eating disorders not otherwise specified" (EDNOS). It may even be difficult to recognize schizophrenia in patients with eating disorders associated to delusional ideas and distorted cognitions related to food or body perception. In any case, the diagnosis of schizophrenia should preferably be made and is only valid after renutrition is achieved. The prevalence of schizophrenia in samples of patients with eating disorders is generally below 10% but reaches 35% in males, the most frequent form being hebephrenia. Cognitive behavioural therapies for eating disorders need to be adapted in cases of comorbid schizophrenia. The new antipsychotic medications seem helpful in patients with eating disorders with or without schizophrenia. They reduce anxiety towards eating and bring in better adherence to treatments.
精神分裂症与饮食失调的共病情况研究不足。在19世纪早期，尤金·布洛伊勒报告了患有饮食失调的精神分裂症病例，这些病例与妄想观念有关。震颤谵妄、食欲倒错和异食癖在精神分裂症患者中经常被描述。患有饮食失调的精神分裂症患者通常不符合典型饮食失调的所有标准，因此被归类为“未另行规定的饮食失调”（EDNOS）。对于与妄想观念以及与食物或身体感知相关的认知扭曲有关的饮食失调患者，甚至可能难以识别出精神分裂症。无论如何，精神分裂症的诊断最好在实现重新营养后进行且才有效。饮食失调患者样本中精神分裂症的患病率一般低于10%，但在男性中达到35%，最常见的形式是青春型精神分裂症。对于共病精神分裂症的情况，饮食失调的认知行为疗法需要进行调整。新型抗精神病药物似乎对伴有或不伴有精神分裂症的饮食失调患者有帮助。它们减少对进食的焦虑，并提高对治疗的依从性。
