Anorexia nervosa and schizophrenia: A case study

✍ Scribed by Sumners, David ;Cohen, Robert I.

• Publisher: Wiley (John Wiley & Sons)
• Year: 1987
• Tongue: English
• Weight: 286 KB
• Volume: 6
• Category: Article
• ISSN: 0276-3478
• DOI: 10.1002/1098-108x(198705)6:3<435::aid-eat2260060315>3.0.co;2-7

✦ Synopsis

A case is presented in which a male patient developed anorexia nervosa and schizophrenia independently. The nosological issues involved are discussed in relation to existing diagnostic systems:

Interest in both anorexia and bulimia nervosa has resulted in increasingly specific diagnostic criteria (Russell, 1979;. The relationship between anorexia nervosa and other psychiatric conditions has been reviewed by Crisp (1967). King (1963) quotes Dejerine and Gauckler (1915), who first differentiated primary and secondary forms of the disorder and concluded that "pri-' mary anorexia forms a specific syndrome, while secondary anorexia is a mixture of various psychiatric states in which anorexia nervosa happened to occur as a pathoplastic development." Slater and Roth (1969) stated that primary anorexia had no depressive or schizophrenic features and that the complete syndrome was rarely seen in secondary cases.

Two current diagnostic systems do not recognize secondary anorexia nervosa. ICD 9 (World Health Organization, 1977) only permits a diagnosis of anorexia nervosa if it is "not manifestly part of a more fundamental classifiable condition." The presence of other syndromes such as schizophrenia precludes the diagnosis of anorexia nervosa. DSM 111 (American Psychiatric Association, 1980) includes in its definition of this disorder "no known physical illness that would account for weight loss." Depressive or physical disorders may lead to the symptom of anorexia but wlll not result in an intense fear of obesity or a distorted body image. DSM I11 recognizes schizophrenia as a cause of bizarre eating patterns, but the "full syndrome of anorexia nervosa is rarely present, when it is given both diagnoses."