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A Journal on Psychiatry, Psychology and Psychopharmacology

Official Journal of the Italian Society of Social Psychiatry
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Minerva Psichiatrica 2001 June;42(2):141-6

language: Italian

Anorexia between autism and delirium

Saya A., Tenaglia T.

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The authors critically review the nosography and psychopathology of anorexia; in particular, they underline the difference between current classifications (using a predominantly descriptive and atheoretical approach, in which anorexia is seen as a homogeneous pathology) and the psychodynamic studies oriented towards grouping this pathology into different types. The authors analyse the correlations between this disorder and autism, alexithymia and delirious ideas. Transversal and longitudinal comorbidity with other syndromes and symptoms is also analysed in the light of the pyschodynamic theory. Autism-like manifestations and a diminished empathic capacity are typical components of a subgroup of anorexic patients, supporting the hypothesis of different pathological types; the finding of alexithymic traits (above all the incapacity of some patients to express emotions) also argues in this direction. This disorder can therefore not be identified with autism, but represents a specific and restricted manifestation of it. The hypothesis of the presence of a psychotic delirious nucleus appears likely, even if a distinction must be drawn with both delirium and real psychosis. Anorexia is not characterised by delirious ideas, but over-valued ideas whose peculiar traits are described by the authors. The hypothesis of anorexia as a psychosis also allows it to be classified into atypical forms since it represents a defence against fragmentation rather than a true psychosis.

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