Life threatening self starvation; a case report

Abstract

BackgroundObsessive compulsive disorders are a complex group that can have a variety of manifestations. Many authors now describe an obsessive compulsive spectrum disorder where many other specific diagnostic entities such as trichotillomania, tic disorders and body dysmorphic disorder are considered to be related and linked disorders.Case presentationWe report a case of a twenty two year old Sri Lankan male who presented with life threatening self starvation due to severe obsessive compulsive disorder. The diagnosis was not considered till late due to the atypical presentation of the patient. While his symptoms bordered on a delusional psychosis, a decision was made to treat him as for obsessive compulsive disorder with behavioural therapy which was successful in the end.ConclusionsIn analysis of a patient with severe anorexia, the psychological causes should not be forgotten. In fact, if the feeding pattern of the patient was observed at the beginning, unnecessary investigating and life threatening worsening of the condition could have been avoided.

Psychiatric Futility and Palliative Care for a Patient With Clozapine-resistant Schizophrenia

“…While our patient did have delusions of immortality related to his belief that God would save him in the final moment, his case did not share the core features of Cotard syndrome (ie, nihilistic delusions or the belief that he was dead). Cases of self-starvation in the setting of obsessive-compulsive disorder have also been reported 13…”

“…Cases of self-starvation in the setting of obsessive-compulsive disorder have also been reported. 13 Psychiatry's Lack of Familiarity With Determining Clinical Futility and Adopting a Palliative Approach Psychiatrists are generally unaccustomed to acknowledging clinical futility. 14 In caring for our patient, we encountered persistently intensifying symptoms of schizophrenia associated with worsening consequences that overwhelmed available treatment options.…”