Mood Disorders in Schizotypal Disorder with Leading Syndrome of Eating Disorders

Abstract

Background: сoverage of the problem of mood disorders in patients with schizotypal disorder with leading eating disorders (EDs), in childhood and adolescence is relevant. However, concomitant disorders in eating disorder in childhood and adolescence and their dynamics have not been sufficiently studied. The aim: to study the clinical and psychopathological structure of mood disorders in patients with schizotypal disorder and eating disorders leading in the clinical picture. Patients and methods: the study included 50 patients (9 boys, 41 girls), aged 7 to 16 years. Inclusion criteria: 1) schizotypal disorder; 2) eating disorders; 3) mood disorders. Research methods: clinical-psychopathological, psychometric (HDRS, PANSS), follow-up, somatic observation. Results: in patients with schizotypal and mood disorders, the following variants of eating disorder were observed: anorexia nervosa (AN — first type), anorexia nervosa with dominance of bulimia (ANB — second type), anorexia nervosa with dominance of bulimia and vomitomania (ANB + B — third type). Mood disorders in the first type of eating disorder were characterized by a pronounced depressive triad, suicidal thoughts and stupor at the cachectic stage of the disease. Mood disorders in the second type of eating disorder were characterized by a mixed affective state: short unproductive mania, ideas of dysmorphophobia, ideas of attitude, followed by a prolonged depressive state with senesto-hypochondriacal disorders, asthenia, and an increase in cognitive impairment. Mood disorders in the third type of eating disorder were characterized by the presence, of pronounced delusional and dysmorphophobic disorders and ideas of attitude, psychopathic behavior, depersonalization-derealization disorders, asthenia and cognitive impairment. Affective pathology in schizotypal disorder with eating disorder, as well as body dysmorphic syndrome, persisted for a long time. The most severe course was observed in the third group of patients (NANB + B), which was due to a significant proportion of psychotic disorders in the structure of the syndrome and somatic complications due to vomiting behavior. Conclusions: patients with schizotypal disorder with leading symptoms of eating disorder and mood disorders require an integrated approach to therapy, including somatic and psychopharmacological treatment.