Milligan Ty, Middleman Amy B
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
SAGE Open Med Case Rep. 2022 Jul 12;10:2050313X221111679. doi: 10.1177/2050313X221111679. eCollection 2022.
Eating disorders can be notoriously difficult to diagnose and treat. This patient is an 18-year-old female who presents to care severely underweight and notably cachexic. For a number of years, she had experienced depressive symptoms, anxiety, and continued loss of appetite. She denied purposefully restricting foods, recognized that she was thin, and denied a fear of gaining weight. She was admitted to a disordered eating unit for refeeding and during her inpatient stay disclosed that she had a long-standing "hatred of face." Ultimately, she received the diagnoses of avoidant/restrictive food intake disorder and body dysmorphic disorder. This case highlights the importance of differentiating body dysmorphia, seen in body dysmorphic disorder, and distorted body image, as seen in anorexia nervosa. This differentiation is significant as the treatment approaches to these distinct diagnoses are not the same.
饮食失调症 notoriously 难以诊断和治疗。该患者为一名18岁女性，前来就诊时体重严重不足且明显消瘦。多年来，她一直有抑郁症状、焦虑情绪，且食欲持续下降。她否认故意限制饮食，意识到自己很瘦，也否认害怕体重增加。她被收治到饮食失调病房进行重新喂养，住院期间她透露自己长期“讨厌自己的脸”。最终，她被诊断为回避/限制性食物摄入障碍和躯体变形障碍。这个病例凸显了区分躯体变形障碍中出现的躯体变形和神经性厌食症中出现的扭曲身体形象的重要性。这种区分很重要，因为针对这些不同诊断的治疗方法并不相同。
