Day Hospital, Eating Disorders Department, ABB Eating Disorders Centre, Barcelona, Spain.
Eat Weight Disord. 2009 Jun-Sep;14(2-3):e139-43. doi: 10.1007/BF03327812.
Psychotic symptoms are a key feature in eating disorders. Restrictive-type anorectics are more prone to suffer them, coherent with recent neurocognitive findings reporting attentional and processing deficits in restrictive anorexia partially common to schizophrenia. Psychotic crises urge psychiatrists to make an accurate differential diagnosis with endogenous psychoses and carefully judge treatment options. If attentively attended, such crises can give us clues to understand the patient s functioning and consider new strategies. We report two transient psychotic episodes in restrictive-type anorectic female patients, one with a previous experience. Onset of psychotic symptoms was related to severe malnutrition only in one of them (body mass index <15). We discuss risk factors, clinical presentation and treatment, focusing on the emotional disturbances maintained after recovery. Causes for psychotic features in these patients are reviewed and treatment individually tailored. An integrative understanding of eating disorders as a unique meeting point between psychosis and neurosis is encouraged.
精神病症状是饮食失调的一个主要特征。限制型厌食症患者更容易出现这些症状，这与最近的神经认知研究结果一致，该结果报告了限制型厌食症中部分与精神分裂症共有的注意力和加工缺陷。精神病危机促使精神科医生对内源性精神病进行准确的鉴别诊断，并仔细判断治疗选择。如果认真对待这些危机，它们可以为我们提供线索，帮助我们了解患者的功能，并考虑新的治疗策略。我们报告了两名限制型厌食症女性患者的短暂精神病发作，其中一名患者有既往病史。精神病症状的发作仅与其中一名患者（体重指数<15）的严重营养不良有关。我们讨论了风险因素、临床表现和治疗，重点是恢复后持续存在的情绪障碍。回顾了这些患者出现精神病特征的原因，并进行了个体化治疗。鼓励以一种综合的方式理解饮食失调，将其视为精神病和神经症之间的独特交汇点。
