Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-05T06:56:42.943Z Has data issue: false hasContentIssue false

Differential diagnosis of anorexia nervosa and obsessive compulsive disorder in a male military veteran

Published online by Cambridge University Press:  26 August 2015

Andrew Kiselica
Affiliation:
Department of Psychology, University of South Florida, Tampa, FL, USA
Renee Brown Hangartner
Affiliation:
Department of Psychology, University of South Florida, Tampa, FL, USA
Adam B. Lewin*
Affiliation:
Departments of Pediatrics, Psychology and Psychiatry & Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
*
*Author for correspondence: A. B. Lewin, Ph.D, ABPP, 880 6th Street South Suite 460, Box 7523, Rothman Center for Neuropsychiatry, USF Pediatrics, St Petersburg, FL 33701, USA (email: [email protected]).

Abstract

Research on the relationship between military service and eating pathology has yielded mixed findings. Among those of military backgrounds, anorexia nervosa typically presents with co-occurring disorders that complicate diagnosis and treatment. The purpose of this paper is to present a case report of a retired Navy midshipman. The patient sought treatment for obsessive compulsive disorder (OCD), but his assessment revealed the primary pathology to be anorexia nervosa. This case illustrates ways in which military life may contribute to eating pathology and the complex overlap and differential diagnosis of anorexia nervosa and OCD.

Type
Practice article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Recommended follow-up reading

Antczak, AJ, Brininger, TL (2008). Diagnosed eating disorders in the U.S. military: a nine-year review. Eating Disorders: The Journal of Treatment & Prevention 16, 363377.Google Scholar
Jones, W, Morgan, JF (2010). Eating disorders in men: a review of the literature. Journal of Public Mental Health 9, 2331.CrossRefGoogle Scholar
Watson, HJ, Bulik, CM (2013). Update on the treatment of anorexia nervosa: review of clinical trials, practice guidelines and emerging interventions. Psychological Medicine 43, 24772500.Google Scholar
Woodside, BD, Staab, R (2006). Management of psychiatric comorbidity in anorexia nervosa and Bulimia Nervosa. CNS Drugs 20, 655663.CrossRefGoogle ScholarPubMed

References

Antczak, AJ, Brininger, TL (2008). Diagnosed eating disorders in the U.S. military: a nine-year review. Eating Disorders: The Journal of Treatment & Prevention 16, 363377.Google Scholar
APA (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Association: Arlington, VA.Google Scholar
Bachelor, A (2013). Clients' and therapists' views of the therapeutic alliance: similarities, differences and relationship to therapy outcome. Clinical Psychology & Psychotherapy 20, 118135.Google Scholar
Beck, AT, Steer, RA (1993). Beck Anxiety Inventory Manual. San Antonio, TX: Psychological Corporation.Google Scholar
Beck, AT, Steer, RA, Brown, GK (1993). Manual for the Beck Depression Inventory – II. San Antonio, TX: Psychological Corporation.Google Scholar
Bodell, L, Forney, KJ, Keel, P, Gutierrez, P, Joiner, TE (2014). Consequences of making weight: a review of eating disorder symptoms and diagnoses in the United States military. Clinical Psychology: Science and Practice 21, 398409.Google Scholar
Carlton, JR, Manos, GH, Van Slyke, JA (2005). Anxiety and abnormal eating behaviors associated with cyclical readiness testing in a naval hospital active duty population. Military Medicine 170, 663667.Google Scholar
Cleary, M, Hunt, GE, Escott, P, Walter, G (2010). Receiving difficult news: views of patients in an inpatient setting. Journal of Psychosocial Nursing and Mental Health Services 48, 4048.Google Scholar
Crane, AM, Roberts, ME, Treasure, J (2007). Are obsessive-compulsive personality traits associated with a poor outcome in anorexia nervosa? A systematic review of randomized controlled trials and naturalistic outcome studies. International Journal of Eating Disorders 40, 581588.Google Scholar
Davidson, DM (1976). Anorexia nervosa in a serviceman: a case report. Military Medicine 141, 617619.Google Scholar
Dellava, JE, Kendler, KS, Neale, MC (2011). Generalized anxiety disorder and anorexia nervosa: Evidence of shared genetic variation. Depression and Anxiety 28, 728733.CrossRefGoogle ScholarPubMed
Fairburn, CG (2008). Cognitive Behavior Therapy and Eating Disorders. New York, NY: Guilford Press.Google ScholarPubMed
Fairburn, CG, Beglin, SJ (1994). Assessment of eating disorders: interview or self-report questionnaire? International Journal of Eating Disorders 16, 363370.Google Scholar
Fairburn, CG, Cooper, Z, Shafran, R (2003). Cognitive behaviour therapy for eating disorders: a ‘transdiagnostic’ theory and treatment. Behaviour Research and Therapy 41, 509528.Google Scholar
Fairburn, CG, Shafran, R, Cooper, Z (1999). A cognitive behavioural theory of anorexia nervosa. Behaviour Research and Therapy 37, 113.Google Scholar
Foa, EB, Huppert, JD, Leiberg, S, Langner, R, Kichic, R, Hajcak, G, Salkovskis, PM (2002). The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological Assessment 14, 485.Google Scholar
Gelegen, C, Pjetri, E, Campbell, IC, Collier, DA, Oppelaar, H, Kas, MJH (2010). Chromosomal mapping of excessive physical activity in mice in response to a restricted feeding schedule. European Neuropsychopharmacology 20, 317326.Google Scholar
Hamlett, KW, Curry, JF (1990). Anorexia nervosa in adolescent males: a review and case study. Child Psychiatry and Human Development 21, 7994.Google Scholar
Hudson, JI, Hiripi, E, Pope, HR, Kessler, RC (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 61, 348358.Google Scholar
Jacobson, IG, Smith, TC, Smith, B, Keel, PK, Amoroso, PJ, Wells, TS, Bathalon, GP, Boyko, EJ, Ryan, MA (2009). Disordered eating and weight changes after deployment: longitudinal assessment of a large US military cohort. American Journal of Epidemiology 169, 415427.Google Scholar
Jiménez-Murcia, S, Fernández-Aranda, F, Raich, RM, Alonso, P, Krug, I, Jaurrieta, N, Alvarez-Moya, E, Labad, J, Menchon, JM, Vallejo, J (2007). Obsessive-compulsive and eating disorders: comparison of clinical and personality features. Psychiatry and Clinical Neurosciences 61, 385391.Google Scholar
Jones, W, Morgan, JF (2010). Eating disorders in men: a review of the literature. Journal of Public Mental Health 9, 2331.Google Scholar
Kozak, MJ, Foa, EB (1997). Mastery of Obsessive Compulsive Disorder: A Cognitive Behavioural Approach (Therapist Guide). Oxford, England: Oxford University Press.Google Scholar
Lewin, AB, Menzel, J, Strober, M (2013). Assessment and treatment of comorbid anorexia nervosa and obsessive-compulsive disorder. In: Handbook of Treating Variants and Complications in Anxiety Disorders (ed. Storch, E. A. and McKay, D.), pp. 337348. New York, NY: Springer.CrossRefGoogle Scholar
Lett, BT, Grant, VL, Smith, JF, Koh, MT (2001). Preadaptation to the feeding schedule does not eliminate activity-based anorexia in rats. Quarterly Journal of Experimental Psychology: Section B 54, 193199.Google Scholar
Litwack, SD, Mitchell, KS, Sloan, DM, Reardon, AF, Miller, MW (2014). Eating disorder symptoms and comorbid psychopathology among male and female veterans. General Hospital Psychiatry 36, 406410.Google Scholar
Maguen, S, Cohen, B, Cohen, G, Madden, E, Bertenthal, D, Seal, K (2012). Eating disorders and psychiatric comorbidity among Iraq and Afghanistan veterans. Women's Health Issues 22, e403e406.CrossRefGoogle ScholarPubMed
McCabe, MP, Ricciardelli, LA (2004). Body image dissatisfaction among males across the lifespan: a review of past literature. Journal of Psychosomatic Research 56, 675685.Google Scholar
McNulty, P (1997). Prevalence and contributing factors of eating disorder behaviors in active duty Navy men. Military Medicine 162, 753758.Google Scholar
McNulty, P (2001). Prevalence and contributing factors of eating disorder behaviors in active duty service women in the Army, Navy, Air Force and Marines. Military Medicine 166, 5358.Google Scholar
Miller, WR, Rollnick, S (2012). Motivational Interviewing: Helping People Change New York, NY: Guilford Press.Google Scholar
Pérez-Padilla, Á, Magalhães, P, Pellón, R (2010). The effects of food presentation at regular or irregular times on the development of activity-based anorexia in rats. Behavioural Processes 84, 541545.CrossRefGoogle ScholarPubMed
Raffin, A, Fachel, J, Ferrão, Y, de Souza, F, Cordioli, A (2009). Predictors of response to group cognitive-behavioral therapy in the treatment of obsessive-compulsive disorder. European Psychiatry 24, 297306.Google Scholar
Ricciardelli, LA, McCabe, MP, Williams, RJ, Thompson, J (2007). The role of ethnicity and culture in body image and disordered eating among males. Clinical Psychology Review 27, 582606.Google Scholar
Robinson, JD, Lupkiewicz, SM, Palenik, L, Lopez, LM, Ariet, M (1983). Determination of ideal body weight for drug dosage calculations. American Journal of Health-System Pharmacy 40, 10161019.Google Scholar
Safran, JD, Muran, JC (2002). Intervention strategies: impasses and transformations. NYS Psychologist 14, 24.Google Scholar
Serpell, L, Livingstone, A, Neiderman, M, Lask, B (2002). Anorexia nervosa: obsessive-compulsive disorder, obsessive-compulsive personality disorder, or neither? Clinical Psychology Review 22, 647669.CrossRefGoogle ScholarPubMed
Smith, C, Klosterbuer, A, Levine, AS (2009). Military experience strongly influences post-service eating behavior and BMI status in American veterans. Appetite 52, 280289.Google Scholar
Staten, RA (2013). Eating disorder in a young active duty male. Military Medicine 178, e884e889.Google Scholar
Steketee, GS (1993). Treatment of Obsessive Compulsive Disorder. New York: Guilford Press.Google Scholar
Striegel-Moore, RH, Garvin, V, Dohm, F, Rosenheck, RA (1999). Psychiatric comorbidity of eating disorders in men: a national study of hospitalized veterans. International Journal of Eating Disorders 25, 399404.Google Scholar
Thornton, LM, Dellava, JE, Root, TL, Lichtenstein, P, Bulik, CM (2011). Anorexia nervosa and generalized anxiety disorder: further explorations of the relation between anxiety and body mass index. Journal of Anxiety Disorders 25, 727730.Google Scholar
Williamson, DA, Martin, PD, Allen, HR, Most, MM, Alfonso, AJ, Thomas, V, Ryan, DH (2002). Changes in food intake and body weight associated with basic combat training. Military Medicine 167, 248253.Google Scholar
Submit a response

Comments

No Comments have been published for this article.