MOH Holdings Pte Ltd., 1 Maritime Square, Singapore 099253, Singapore.
Institute of Mental Health, 10 Buangkok View, Buangkok Green, Medical Park, Singapore 539747, Singapore.
Int J Environ Res Public Health. 2022 Apr 17;19(8):4874. doi: 10.3390/ijerph19084874.
Eating disorders (EDs) are complicated mental illnesses with significant treatment resistance and dropout rates. For successful treatment, it is important for clinicians to better understand the patients' narrative and their lived experiences. A thorough psychodynamic understanding of patients' childhood attachment and primary relationships, personality traits and mental processes is, therefore, crucial for managing patients with ED. Interestingly, several studies have observed an association between functional urinary symptoms and individuals with ED. EDs such as anorexia nervosa are associated with an increased risk of all urinary symptoms, and functional incontinence was also more common in extreme female athletes with low energy availability and with disordered eating. There is, however, a dearth of literature describing this relationship, and the underlying mechanisms remain remote. In this paper, we present a psychoanalytic approach to the presence of urinary symptoms in females with EDs. We hypothesize that these symptoms are tied to specific traits or characteristics of ED patients, namely the overarching need for control, a pathological strive for perfection and the self-denial of basic bodily urges. This is discussed in relation to psychopathological processes, development and personality factors commonly seen in patients with ED.
进食障碍（EDs）是复杂的精神疾病，具有显著的治疗抵抗和辍学率。为了成功治疗，临床医生了解患者的叙述和他们的生活经历非常重要。因此，深入了解患者的儿童期依恋和主要关系、人格特质和心理过程对于管理 ED 患者至关重要。有趣的是，几项研究观察到功能性尿症状与 ED 个体之间存在关联。神经性厌食症等 ED 与所有尿症状的风险增加有关，在能量供应不足和饮食失调的极端女性运动员中，功能性尿失禁也更为常见。然而，描述这种关系的文献很少，其潜在机制仍然很遥远。在本文中，我们提出了一种对 ED 女性尿症状的精神分析方法。我们假设这些症状与 ED 患者的特定特征或特征有关，即对控制的总体需求、对完美的病态追求以及对基本身体冲动的自我否定。这与 ED 患者常见的心理病理过程、发展和人格因素有关。
