Department of Psychiatry and Mental Health, Baixo Vouga Hospital Centre, Aveiro, Portugal.
Psychiatry and Mental Health Clinic, São João University Hospital Centre, Porto, Portugal.
Rev Assoc Med Bras (1992). 2020 Dec;66(12):1736-1741. doi: 10.1590/1806-9282.66.12.1736.
The interplay between eating disorders and psychosis is a challenging field to which little attention has been paid. Its study raises conceptual and methodological questions in both areas, making the diagnosis and management of patients difficult. Such questions are addressed and illustrated with a review and case report.
The authors present the case of a woman with Anorexia Nervosa and with comorbid Shared Psychotic Disorder, based on a literature review regarding the comorbidity between eating disorders and psychosis. The authors conducted a non-systematic review by searching the PubMed database, using the Mesh Terms "anorexia nervosa", "bulimia nervosa", "comorbidity" and "psychotic disorders".
The findings suggest that studies on the subject are limited by issues regarding data on the prevalence of comorbidities, phenomenological aspects of eating disorders, and the interface and integration with psychotic symptoms.
The case presented illustrates the difficulties in managing a patient with a comorbid eating disorder and psychosis. In order to ensure a rigorous assessment of both psychotic and eating disorder symptoms, the focus should be on the pattern of appearance or emergence of symptoms, their phenomenology, clinical and family background of the patient, and clinical status on follow-up.
饮食失调和精神病之间的相互作用是一个具有挑战性的领域，很少有人关注。它的研究在这两个领域都提出了概念和方法上的问题，使得患者的诊断和治疗变得困难。通过回顾和案例报告来解决和说明这些问题。
作者根据关于饮食失调和精神病共病的文献综述，介绍了一位患有神经性厌食症和并发共享精神病性障碍的女性的病例。作者通过在 PubMed 数据库中搜索 Mesh 术语“神经性厌食症”、“神经性贪食症”、“共病”和“精神病性障碍”进行了非系统性综述。
研究结果表明，由于关于共病患病率、饮食失调的现象学方面以及与精神病症状的接口和整合等问题，对该主题的研究受到限制。
所呈现的病例说明了管理患有共病饮食失调和精神病的患者的困难。为了确保对精神病和饮食失调症状进行严格评估，重点应放在症状的出现或出现模式、症状的现象学、患者的临床和家庭背景以及随访中的临床状况上。
