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Yıl:2007; Cilt: 18; Sayı: 1>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2007;18(1):87-91
Olgu Sunumu: Bir Erkek Hastada Anoreksiya Nervoza ve Şizofreni Eşhastalanımı
B Cinemre, B Kulaksızoğlu
Akdeniz Ü Tıp Fak., Psikiyatri AD., Antalya
Anoreksiya nervoza toplumda nadir görülen bir psikiyatrik bozukluktur ve epidemiyolojik çalışmalar 10 kadına karşılık bir erkek oranıyla daha çok kadın cinsiyete özgü bir hastalık olduğunu göstermektedir. Anoreksiya nervozanın başka psikiyatrik bozukluklarla eşhastalanım oranı oldukça yüksektir. Anoreksiya nervozaya eşlik eden psikiyatrik bozukluklar arasında depresyon ve anksiyete bozuklukları başta gelirken, anoreksiya nervoza-şizofreni ikili tanısı görece nadir bir durumdur. Genellikle, olgu ya da olgu serilerine dayanarak anoreksiya nervoza-şizofreni birlikteliğine ilişkin değişik açıklamalar yapılmıştır. Bu yazıda 14 yaşında zayıflama kararıyla başlayan, yeme davranışı ve beden algısında bozulmayla seyreden 4 yıllık bir anoreksik dönemden sonra, şizofreni tablosu gelişen bir erkek hasta olgu olarak sunulmuştur. Bu olgu iki açıdan nadir bir olgu olarak değerlendirilmiştir. Bunlardan biri hastanın erkek olması, diğeri de anoreksiya nervoza-şizofreni eştanılarını almış olmasıdır. Nitekim, literatürde şimdiye kadar anoreksiya nervoza tanısıyla birlikte şizofreni tanısı alan tek bir erkek hasta bildirilmiştir. Bu olgu sunumuyla öncelikle erkeklerde anoreksiya nervoza tanısı ele alınmıştır. Bunun yanı sıra, anoreksiya nervoza tanısında eşikaltı durumların tanımı ve önemi tartışılmış; konuyla ilgili literatür ışığında anoreksiya nervoza-şizofreni eşhastalanımına dair açıklamalar gözden geçirilmiştir.
Case Report: Comorbid Anorexia Nervosa and Schizophrenia in a Male Patient
Anorexia nervosa is a rare psychiatric disorder and epidemiological studies have shown a female to male ratio of 10:1, suggesting it is a disorder predominantly seen among females. The prevalence of anorexia nervosa comorbid with other psychiatric disorders has been reported to be quite high. Whereas depression and anxiety disorders are the most common comorbid diagnoses in anorexic patients, the dual-diagnosis of anorexia and schizophrenia is a relatively rare condition. Based generally on the observations from single case reports or case series, several explanations have been made about the co-occurrence of anorexia and schizophrenia. Herein, we present a male patient who developed schizophrenia after an anorexic period of 4 [year]s that began when he was 14 [year]s old with the decision to lose weight, which then progressed to a pattern of disordered eating and body image. This case is rare because the patient is male and has a comorbid diagnosis of anorexia nervosa and schizophrenia. To the best of our knowledge, there is only one previous case report in the literature describing a male anorexic patient with comorbid schizophrenia. In this case presentation, the diagnosis of anorexia nervosa in males is addressed, the definition and significance of sub-threshold cases are discussed, and the comorbidity of anorexia nervosa and schizophrenia are reviewed in light of the literature.

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