PDF(Pubmed)
Abstract：
Eating disorders (EDs) are among the most dangerous mental illnesses, that are characterized by high mortality rates, multisystem comorbidity, and an often chronic and relapsing disease course. EDs occur most commonly in the female gender, with a ratio of 10 females to 1 male for anorexia nervosa (AN). We present the case of a 15-year-old Saudi boy who presented with weight loss (BMI 11.6 kg/m2) and began to have symptoms of obsessive-compulsive disorder (OCD) in prayer and ablution. His first treatment plan was psychoeducation. He then developed a fear of gaining weight and began to count calories; he was diagnosed with AN and started on olanzapine 2.5 mg. The patient had a history of multiple admissions due to electrolyte imbalance, hypokalemia, hypoglycemia, and anal fissure due to constipation, and was prescribed olanzapine 5 mg, fluoxetine 20. His last admission was the worst, as he became semi-comatose with a Glasgow Coma Scale (GCS) of 13, was diffused and disoriented to time and person, unable to walk or sit, and was uncooperative in answering questions. During admission, we changed the fluoxetine to paroxetine 25 mg and increased the olanzapine to 10 mg, and the patient showed a huge improvement physically and mentally. This case emphasizes the significance of including paroxetine in the treatment of diagnoses for AN to prevent unnecessary wasting of time and effort.
摘要：
进食障碍（ED）是最危险的精神疾病之一，其特点是死亡率高，多系统共病，和经常慢性和复发性疾病的过程。ED最常见于女性，神经性厌食症（AN）的比例为10名女性对1名男性。我们介绍了一个15岁的沙特男孩，该男孩体重减轻（BMI11.6kg/m2），并开始在祈祷和沐浴中出现强迫症（OCD）的症状。他的第一个治疗方案是心理教育。然后，他开始担心体重增加，并开始计算卡路里；他被诊断出患有AN，并开始服用奥氮平2.5mg。由于电解质失衡，患者有多次入院史，低钾血症,低血糖,便秘引起的肛裂,服用奥氮平5mg，氟西汀20.他最后一次承认是最糟糕的，当他变得半昏迷时，格拉斯哥昏迷量表（GCS）为13，被人和时间分散和迷失方向，不能走路或坐,在回答问题时不合作。入院期间,我们将氟西汀改为帕罗西汀25毫克，将奥氮平增加到10毫克，病人在身体和精神上都有了巨大的改善。该案例强调了在AN的诊断治疗中包括帕罗西汀以防止不必要的时间和精力浪费的重要性。
