Mary V Seeman, Department of Psychiatry, University of Toronto, Toronto, Ontario M5S 1A8, Canada.
World J Psychiatry. 2014 Dec 22;4(4):112-9. doi: 10.5498/wjp.v4.i4.112.
Psychotic disorders and eating disorders sometimes occur in the same person, and sometimes, but not always, at the same time. This can cause diagnostic confusion and uncertainty about treatment. This paper examines seven ways in which symptoms of both conditions can co-exist. The literature on this topic consists to a large extent of case reports, so that firm conclusions cannot be drawn from their examination. There is no consistent sequence in the co-occurrence of the two conditions-eating disorders sometimes precede, and sometimes follow the onset of psychosis. The advent of the psychosis, and sometimes the treatment of the psychosis can cure the eating disorder, but it can sometimes aggravate it. Psychosis is not necessarily a mark of severity in the course of an eating disorder, and food refusal can occur independent of severity in psychotic illness, but it can be a cause of death. There is some genetic association and some overlap of physiologic, cognitive and brain structure deficits in the two types of disorder. The connection between the two, however, remains speculative. The area of comorbidity and overlapping symptoms in psychiatry requires more research. Clinical recommendations include attention to the different individual ways in which these two disparate conditions often overlap.
精神障碍和饮食障碍有时会同时发生在同一个人身上，有时是同时发生，有时则不是。这可能会导致诊断混淆和治疗不确定。本文探讨了这两种病症同时存在的七种方式。这一主题的文献主要由病例报告组成，因此不能从这些检查中得出确凿的结论。这两种病症的同时发生没有一致的顺序——饮食障碍有时先于精神障碍发生，有时后于精神障碍发生。精神障碍的出现，有时是精神障碍的治疗，可以治愈饮食障碍，但有时也会加重饮食障碍。精神障碍不一定是饮食障碍病程严重程度的标志，拒绝进食也可能独立于精神疾病的严重程度而发生，但它可能是死亡的原因。这两种类型的障碍在遗传上存在关联，在生理、认知和大脑结构缺陷上也存在重叠。然而，两者之间的联系仍然是推测性的。精神病学中合并症和重叠症状的领域需要更多的研究。临床建议包括关注这两种截然不同的病症经常重叠的不同个体方式。
