title: Psychogenic vomiting complicated by marijuana abuse and spontaneous pneumomediastinum.
abstract: OBJECTIVE
  This case illustrates an unusual physical sequel of psychogenic vomiting.
  
  
  METHODS
  A 22-year-old man with a picture of psychogenic vomiting and marijuana use developed the complications of a pneumomediastinum and subcutaneous emphysema.
  
  
  METHODS
  Therapy included gradual exposure to anxiety provoking stimuli, psychotropics to reduce vomiting and psychotherapeutic exploration of family relationships.
  
  
  RESULTS
  The patient's vomiting and physical state resolved without complication. Follow-up at 12 months revealed continued improvement with occasional less severe vomiting.
  
  
  CONCLUSIONS
  Psychogenic vomiting as a manifestation of anxiety can result in serious physical and psychological sequelae. This patient's desperate attempts to control such vomiting complicated the picture. Successful short term intervention included the use of several treatment modalities.
authors.affiliation: Department of Psychiatry, Westmead Hospital, New South Wales, Australia.
authors.forename: G M
authors.initials: GM
authors.lastname: de Moore
authors.forename: J
authors.initials: J
authors.lastname: Baker
authors.forename: T
authors.initials: T
authors.lastname: Bui
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D006801:Humans; D007389:Internal-External Control; D008297:Male; D002189:Marijuana Abuse / Q000150:complications* / Q000523:psychology / Q000534:rehabilitation; D008478:Mediastinal Emphysema / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D009034:Mother-Child Relations; D009325:Nausea / Q000150:complications / Q000523:psychology / Q000628:therapy; D010348:Patient Care Team; D010553:Personality Development; D011602:Psychophysiologic Disorders / Q000150:complications* / Q000523:psychology / Q000628:therapy; D013352:Subcutaneous Emphysema / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D014839:Vomiting / Q000150:complications* / Q000523:psychology / Q000628:therapy