Anorexia Nervosa and Obsessive Compulsive Disorder
It has long been recognized that there are similarities between Obsessive Compulsive Disorder (OCD) and Anorexia Nervosa. These similarities lie in the symptoms of the disorder. Many patients of both diseases report intrusive, fearful thoughts, a compulsive need to perform rituals, and an obsession with maintaining these rituals. In the case of anorexia nervosa these behaviors center on food and thinness whereas in OCD they are of a more general type.
Past research has indicated that there is a higher prevalence rate for OCD among anorexia nervosa patients then in the normal population. The lifetime prevalence for OCD has been found to be around 3%. Conversely, the comorbidity rate for OCD and anorexia has been reported to be between 6% and 33%! This leads one to hypothesis that there may be a relationship between OCD and anorexia nervosa. It is not clear yet, based on the present research, what this relationship is. But, there are many studies out there that try to examine the relationship as well as its underlying causes. In this literature review some of this research will be examined and some preliminary conclusions will be drawn. Finally, further research to explore this relationship will be proposed.
Anorexia nervosa is a specific disorder defined in DSM IV. Several classifications must be met for a diagnosis of anorexia to be made. There must be a refusal by the patient to maintain a healthy body weight for their age and height. This behavior must eventually lead to a weight loss in which the body weight falls to less then 85% of the persons ideal body weight. Or the patient can refuse to gain any weight during periods of growth. In women that have begun menstruation, the absence of three or more periods consecutively is a qualifying factor of a diagnosis of anorexia.
Anorexia is also defined by a distorted body image. This is harder to define but the patient usually experiences an intense fear of gaining weight. There is also a distorted way in which the body is viewed. Patients that have lost more than 85% of their body weight still feel that they are too heavy and must continue to lose.
There are two subtypes of anorexia. The binge eating/ purging subtype does not seem to be linked to the ritualistic behavior of OCD. The restricting subtype is the one that has been found to have a high comorbidity with OCD. This subtype involves restrictive behavior to lose weight. The subject restricts their food intake and does not misuse laxatives or diuretics.
The treatment for anorexia has usually been counseling. Sometimes the starvation is so bad that the patients must be hospitalized and fed intravenously or through a nasogastric tube. When they are well enough, counseling is begun. This may be individual or family therapy. The treatment process usually spans several months to several years.
Obsessive Compulsive Disorder (OCD)