P03-550 - Delusional disorder with severe weight loss

Introduction Delusional disorder is an illness characterized by the presence of non bizarre delusions in the absence of other mood or psychotic symptoms. Objectives Subtypes of delusional disorder are defined as erotomanic, grandiose, jealous, persecutory, somatic, mixed and unspecified. We will present a case of somatic subtype. Aims The core belief of somatic type of this disorder is delusions around bodily functions and sensation, the presence of an infection or a disease. Methods We report on a 40 years old female with delusional disorder who had a severe weight loss during last two years. Her weight was 60 kgr and she became 29 kgr. Her BMI was less than 12. She was brought to a general hospital because of her severe malnutrition and somatic symptoms such as weakness, fatigue, dizziness. Her blood exams were abnormal because of starvation. She also had amenorrhea. After taking first aid treatment from general practicians she was transferred to our psychiatric clinic with their diagnosis anorexia nervosa. Her mental status examination was normal with exception of the abnormal delusional belief that she had a serious gastroenterological disease and any food could cause her pain in stomach and other gastroenterological annoyances. She had visited at past many gastroenterologists and she had done many laboratory exams with no abnormal result. In differential diagnosis she was not anorectic because she did not like her skinny appearance and avoid looking herself at mirrors. Results She was treated with olanzapine and gained weight. Conclusions In somatic type of delusional disorder the patient is totally convinced in physical nature of his disorder.