Obsessive-compulsive disorder and anorexia nervosa in a high school athlete: a case report.

OBJECTIVE

To describe the case of a basketball and track athlete who presented with both anorexia nervosa and obsessive- compulsive disorder (OCD).

BACKGROUND

OCD is a psychiatric condition known to appear with significant frequency among those with anorexia. Although treatable with drug and behavioral therapy, it must be specifically sought because some of its symptoms are similar to those of anorexia nervosa.

DIFFERENTIAL DIAGNOSIS

Obsessive-compulsive disorder, anxiety disorder.

TREATMENT

Behavioral therapy involves exposure to the obsessive fears without allowing the patient to ritualize. This is best used in combination with drugs that selectively block the reuptake of serotonin in the brain.

UNIQUENESS

Anorexia nervosa is notoriously difficult to treat. In our patient, anorexic symptoms all but disappeared along with the OCD in a matter of weeks, once treatment of the OCD began. Lengthy treatment for anorexia alone had been unsuccessful.

CONCLUSIONS

OCD occurs frequently in patients with anorexia, and successful treatment requires that both conditions be specifically identified and managed. Athletic trainers may be the first to recognize key signs and symptoms of this illness; by referring the individual for psychiatric evaluation, they can be instrumental in helping the patient to obtain appropriate treatment.