Comorbidity of obsessive-compulsive disorder and anorexia nervosa - diagnostic difficulties: a case study of a 14-year old girl

PURPOSE: The objective of this paper is to present the comorbidity of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) and to note the need for caution during the diagnostic process. CASE DESCRIPTION: We present a case of a 14-year old girl raised in a reconstructed family. The primary diagnosis was AN, which was changed to OCD in the course of hospitalisation. Symptoms of OCD and AN occurred in close time proximity and involved excessive focus on appearance, beautifying rituals disrupting circadian rhythm, rigid behaviours, school absence, and social isolation. In further therapy, schizotypal personality disorder was suspected. Pharmacotherapy involved SSRI drugs: sertraline followed by fluoxetine. COMMENT: OCD has a complex aetiology and a chronic course. However, proper management allows obtaining satisfactory control and enables the patient to function in society. The focus on anorexia in the diagnostic process can distract attention from the underlying disorders.