Womperski Karol, Woźniak Justyna
Faculty of Medicine, Wrocław Medical University, Wrocław, Poland.
Postep Psychiatr Neurol. 2021 Mar;30(1):52-60. doi: 10.5114/ppn.2021.106820. Epub 2021 Jun 10.
The objective of this paper is to present the comorbidity of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) and to note the need for caution during the diagnostic process.
We present a case of a 14-year old girl raised in a reconstructed family. The primary diagnosis was AN, which was changed to OCD in the course of hospitalisation. Symptoms of OCD and AN occurred in close time proximity and involved excessive focus on appearance, beautifying rituals disrupting circadian rhythm, rigid behaviours, school absence, and social isolation. In further therapy, schizotypal personality disorder was suspected. Pharmacotherapy involved SSRI drugs: sertraline followed by fluoxetine.
OCD has a complex aetiology and a chronic course. However, proper management allows obtaining satisfactory control and enables the patient to function in society. The focus on anorexia in the diagnostic process can distract attention from the underlying disorders.
本文旨在介绍神经性厌食症（AN）与强迫症（OCD）的共病情况，并指出在诊断过程中需要谨慎。
我们呈现了一名在重组家庭中长大的14岁女孩的病例。初步诊断为AN，在住院过程中改为OCD。OCD和AN的症状在时间上紧密相连，包括过度关注外表、扰乱昼夜节律的美化仪式、刻板行为、缺课以及社交隔离。在进一步治疗中，怀疑存在分裂型人格障碍。药物治疗使用了选择性5-羟色胺再摄取抑制剂（SSRI）类药物：先使用舍曲林，后使用氟西汀。
OCD病因复杂，病程呈慢性。然而，恰当的管理可实现令人满意的控制，并使患者能够融入社会。诊断过程中对厌食症的关注可能会分散对潜在疾病的注意力。
