Detailed contribution information
| Contribution title | An adolescent with an eating disorder and psychotic symptoms – a diagnostic dilemma and a therapeutic approach |
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| Contribution code | D1.082 |
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| Form of presentation | Poster |
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| Abstract |
Receiving a diagnosis during adolescence can be a pivotal moment in a patient’s development, but making an accurate diagnosis is often challenging for child psychiatrists. We present an interesting case of a 17-year-old female patient that clearly illustrates this challenge. At 13, she developed anxiety and depressive symptoms accompanied by self-destructive behavior and signs of an eating disorder, leading to a diagnosis of an emotional disorder beginning in childhood. By 15, she was diagnosed with bulimia nervosa, marked by daily compensatory vomiting, laxative abuse, delusional beliefs about being overweight, intense fear of weight gain, and lack of insight in illness. These symptoms persisted for years with the same severity. She also displayed traits indicative of borderline personality disorder, such as emotional instability, impulsive self-destructive behavior, paranoid ideation under stress, and narcissistic traits (vulnerability and perfectionism). Additionally, her delusional thoughts about food, negative symptoms, and impaired interpersonal and academic functioning met criteria for early psychotic disorder. Her symptoms pose a diagnostic dilemma: are they rooted in bulimia nervosa with a comorbid personality disorder, or do they signal early onset of psychosis? Continuous re-evaluation and symptom monitoring have guided her individualized, multimodal treatment approach. Conclusion: Diagnosing in adolescent psychiatry is complex and impactful. Early-onset schizophrenia focuses mostly on symptoms and social functioning, while personality disorders emphasize social functioning as well as behavior, self-perception and impulsivity. A diagnosis profoundly affects adolescents’ functioning and willingness to seek treatment. Individualized and multimodal treatment was applied. |