title: Successful anterior capsulotomy in comorbid anorexia nervosa and obsessive-compulsive disorder: case report.
abstract: BACKGROUND
  State-of-the-art treatment of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) often proves ineffective. Both disorders have common features, and anterior capsulotomy is a last-resort treatment for OCD. We document the effect of bilateral anterior capsulotomy in a patient with comorbid AN and OCD.
  
  
  METHODS
  A 38-year-old woman with life-threatening, chronic, treatment-refractory AN and OCD underwent anterior capsulotomy. Psychiatric and neuropsychological evaluations at baseline and at follow-up document the severity and progress of the case. Bilateral anterior capsulotomy resulted in normalization of eating pattern and weight and a significant decrease of food-related and overall obsessive-compulsive symptoms. Psychiatric evaluations and exposure to food cues confirmed the clinical improvement that was evident immediately after surgery and sustained at 3-month follow-up.
  
  
  CONCLUSIONS
  This case report suggests that bilateral anterior capsulotomy can be a therapeutic option for patients with comorbid AN and OCD. However, a well-controlled study is warranted.
authors.affiliation: Departmentsof Neurosciences and Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium. johanbarbier@hotmail.com
authors.forename: Johan
authors.initials: J
authors.lastname: Barbier
authors.forename: Loes
authors.initials: L
authors.lastname: Gabriëls
authors.forename: Koen
authors.initials: K
authors.lastname: van Laere
authors.forename: Bart
authors.initials: B
authors.lastname: Nuttin
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications* / Q000523:psychology / Q000601:surgery*; D003463:Cues; D005260:Female; D019788:Fluorodeoxyglucose F18; D005502:Food; D006801:Humans; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000379:methods*; D009771:Obsessive-Compulsive Disorder / Q000150:complications* / Q000523:psychology / Q000601:surgery*; D049268:Positron-Emission Tomography; D011569:Psychiatric Status Rating Scales; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D013238:Stereotaxic Techniques; D013687:Telencephalon / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18