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KMID : 0378019840270120061
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New Medical Journal
1984 Volume.27 No. 12 p.61 ~ p.66
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A Case of Anorexia Nervosa Resulting in Severe Cachexia
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Abstract
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Anorexia nervosa is a disorder characterized by peculiar patterns of handling food, compulsive refusal of food, severe weight loss, and amenorrhea especially in young women.
Literature shows that the disease is commonly caused by psychological stress primarily. However, recent study reveals that it may be an organic disorder caused by endocrine dysfunction, especially of the hypothalamus.
We reported a case of a 27-year-old woman admitted to our psychiatric in-patient ward in the state of 19kg of body weight, amenorrhea and seemingly severe cachexia. She was 57 percent below the premorbid weight, which had been reduced for three years, with the cessation of menstruation during that period.
On physical examination and laboratory assessment, mild brain atrophy and iron-deficiency anemia, endocrine abnormality were revealed.
On psychological tests, it was possible to guess conversion disorder. And the psychodynamic explanation might be that the patient had regressed to the infantile level for the gratification of the dependent need.
The patient was treated in the hospital with a supportive psychotherapy and symptomatic treatment, antidepressant (amitriptyline, 150mg/day), antipsychotic (chlorpromazine, 400 mg/day), and showed considerable response to the given treatment. She was discharged weighing 39kg. She gained weight steadily throughout her out-patient course and by ten months after the initiation of treatment, she regained the premorbid body weight (45kg), and the regular menstruation. And she was able to establish a satisfactory relationship with the surroundings.
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