A treatment strategy for psychogenic vomiting.

Although the literature supports the existence of psychogenic vomiting as a distinct psychiatric disorder, the DSM III-R does not include it as a diagnostic category. Of the numerous articles in the literature which describe this disorder, few discuss treatment. The purposes of this paper are to review the existing literature, to describe the family dynamics which are thought to precipitate the evolution of psychogenic vomiting in the identified patient, and to describe a treatment protocol which has been successfully employed in an outpatient setting. The illness is characterized as an eating disorder in terms of etiology, symptomatology, and treatment. A treatment strategy is described which includes insight-oriented psychotherapy with cognitive/behavioral interventions and family therapy. Two case studies are included which illustrate that a combined therapy approach is efficacious in treating psychogenic vomiting.