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PAPERS: Gabriella Milos, Anja Spindler, Ulrich Schnyder, and Christopher G. Fairburn Instability of eating disorder diagnoses: prospective study The British Journal of Psychiatry 2005; 187: 573-578 [Abstract] [Full text] [PDF]

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To Vomit or Not to Vomit?

Yasir Abbasi, Witheld   (22 December 2005)

To Vomit or Not to Vomit? 22 December 2005
Yasir Abbasi, SHO in Child and Adolescent Psychiatry Dr Justin Schlicht, Witheld Send letter to journal: Re: To Vomit or Not to Vomit? dryiabbasi{at}yahoo.com Yasir Abbasi, et al.	This prospective study about the ‘instability of eating disorder diagnoses’ seems quite appealing and attention-grabbing to the reader. It particularly interested me because we currently have several patients diagnosed with Anorexia Nervosa at our adolescent inpatient unit. Even though they all seem to be recuperating with time, but they are still far from showing a diagnostic flux at the moment. One patient, surprisingly, doesn’t show the classical ‘distorted body image’ symptom currently but still continues to make herself sick. On numerous occasion she has mentioned to be vomiting as acts of self harm (she also cuts herself superficially at regular intervals) and continues to feel that it is a coping mechanism for her under undue stress. She is currently on no medication and we have managed to increase and maintain her weight in the past four months above 45 kg successfully with the help of the nurses, dietician and occupational therapist on the unit. My question here is, would we still consider her diagnoses as Anorexia Nervosa or are we seeing a diagnostic flux into a completely different dimension of personality problems?