SUMMARY INTRODUCTION: The interplay between eating disorders and psychosis is a challenging field to which little attention has been paid. Its study raises conceptual and methodological questions in both areas, making the diagnosis and management of patients difficult. Such questions are addressed and illustrated with a review and case report. METHODS: The authors present the case of a woman with Anorexia Nervosa and with comorbid Shared Psychotic Disorder, based on a literature review regarding the comorbidity between eating disorders and psychosis. The authors conducted a non-systematic review by searching the PubMed database, using the Mesh Terms “anorexia nervosa”, “bulimia nervosa”, “comorbidity” and “psychotic disorders”. RESULTS: The findings suggest that studies on the subject are limited by issues regarding data on the prevalence of comorbidities, phenomenological aspects of eating disorders, and the interface and integration with psychotic symptoms. CONCLUSIONS: The case presented illustrates the difficulties in managing a patient with a comorbid eating disorder and psychosis. In order to ensure a rigorous assessment of both psychotic and eating disorder symptoms, the focus should be on the pattern of appearance or emergence of symptoms, their phenomenology, clinical and family background of the patient, and clinical status on follow-up.

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▪ Schizophrenia (SZ) and Bipolar Disorder (BD) are debilitating neuropsychiatric conditions, often considered as a part of a continuum of psychotic disorder. 1 Cognitive abnormalities have been widely described, with studies showing large deficits in SZ and only milder deficits in BD. 2 These are related to functional outcome and are stable throughout the course of the disorder. 3,4 ▪ One of the most fundamental cognitive functions is attention. Attentional deficits are reported quite frequently in SZ and BD, with patients being more susceptible to the interference of task-irrelevant stimuli. 5,6 Of particular interest is the interference of facial expressions in SZ and BD, given their emotional deficits. 7 However, studies comparing both conditions are still scarce. 8 ▪ Aim: To explore the interference of facial expressions by manipulating the perceptual load, a determinant for selective attention. 9 Participants ▪ 22 outpatients with SZ, clinically stable and medicated; ▪ 20 outpatients with BD, euthymic and medicated; ▪ 22 healthy controls, age and gender-matched, with not no personal history of psychiatric disorders and no first-degree relative with psychotic disorder.Target-letter discrimination task (Fig. 1) ▪ Participants were positioned in front of a computer screen, and were asked to discriminate a target-letter (X or N) among distractor-letters and to ignore the presence of a task-irrelevant figure. Participants should press, as quickly and accurately as possible, the discriminated letter on the keyboard. ▪ The distractor-letters could be identical (low load; less demanding task) or different (high load; more demanding task). The task-irrelevant figure consisted of a happy, angry or neutral face. The order of the conditions and stimuli was fully randomized. ▪ Participants completed 384 trials, equally distributed by load and emotion conditions. Response time (ms) and accuracy were analysed.