[Extensive interactions between eating and weight disorder,  major depression, pain, and sarcoidosis - case 5/2012].
METHODS
We report on a 41-year-old female patient suffering from obesity, binge eating more than twice a week with loss of control, eating rapidly and feeling guilty after eating, dyspnoea and chronic pain in the whole body, especially in her arms, legs and in both ankles. Furthermore, subdued mood, loss of interest and pleasure, fatigue and impaired concentration could be recognized. In the past, weight increase had been observed when corticosteroids were given against exacerbations of sarcoidosis.


METHODS
In the case of our patient, the beginning of sarcoidosis and increase of weight and pain correlated with augmentation of depression and psychosocial stress. Dysfunctional behavioral features and multiple interactions between diseases could be observed.


METHODS
We diagnosed obesity, binge eating disorder, major depression, chronic pain disease with somatic and psychical components and sarcoidosis. The patient was treated in a multimodal therapy program including psychotherapy, pharmacotherapy and psychopharmacotherapy, nutritionist advice and therapeutic exercise. A weight loss of 7.9 kg (5.9 %), well-balanced diet, reduction of binge eating and of pain intensity, mood stabilization as well as perception and expression of emotions and coping strategies in chronic diseases were achieved.


CONCLUSIONS
Interdisciplinary treatment of patients suffering from psychosomatic, somatic and mental diseases is crucial for a good outcome.
Abteilung für Psychosomatische Medizin und Psychotherapie, Medizinische Universitätsklinik Tübingen.
Eva
E
Schäflein
Irmtraud
I
Wettach
Robert
R
Smolka
Jürgen
J
Kuprion
Stephan
S
Zipfel
Martin
M
Teufel
D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D056912:Binge-Eating Disorder / Q000139:chemically induced* / Q000523:psychology / Q000628:therapy; D015992:Body Mass Index; D059350:Chronic Pain / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D003299:Cooperative Behavior; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D009765:Obesity / Q000139:chemically induced* / Q000523:psychology / Q000628:therapy; D010147:Pain Measurement; D010343:Patient Admission; D011379:Prognosis; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D013315:Stress, Psychological / Q000150:complications; D015430:Weight Gain / Q000187:drug effects*
D000305:Adrenal Cortex Hormones; D000928:Antidepressive Agents