Factitious Disorder を来した Anorexia Nervosa の1例

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We reported a case of anorexia nervosa which developed into factitious disorder during the 15-year course of the disease. The patient was a 30-year-old female. She became anorectic with an unbalanced diet and vomiting after entering high school and her body weight fell to 26 kg. It was supposed that typical anorexia nervosa first developed at that time. She had had neither medical nor psychiatric treatment for a long time, and when her symptoms improved a little and her weight loss was not so prominent, sexual acting out and other delinquent behaviors occurred. The course of her illness showed waxing, waning and shifting. It finally reached Factitious Disorder, whose symptoms were abnormality of serum electrolytes, hemorrhagic tendency caused by a deficiency of vitamin K-dependent coagulation factors, and anemia due to blood-letting on the part of the patient. She was first referred to our psychiatric department for her self-centered and exaggerated behavior. By stopping vomiting and blood-letting through forced therapy in a closed ward, electrolyte abnormalities and coagulation were improved and she was discharged three months after admission. But after discharge she began, though slight in degree, anorectic behavior and vomiting again, and presented features of anorexia nervosa. Thus, we considered the case primarily as being anorexia nervosa which developed into factitious disorder in the course of medical treatment.
日本心身医学会の論文
1986-06-01

Factitious Disorder を来した Anorexia Nervosa の1例

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