Life threatening self starvation; a case report.
BACKGROUND
Obsessive compulsive disorders are a complex group that can have a variety of manifestations. Many authors now describe an obsessive compulsive spectrum disorder where many other specific diagnostic entities such as trichotillomania, tic disorders and body dysmorphic disorder are considered to be related and linked disorders.


METHODS
We report a case of a twenty two year old Sri Lankan male who presented with life threatening self starvation due to severe obsessive compulsive disorder. The diagnosis was not considered till late due to the atypical presentation of the patient. While his symptoms bordered on a delusional psychosis, a decision was made to treat him as for obsessive compulsive disorder with behavioural therapy which was successful in the end.


CONCLUSIONS
In analysis of a patient with severe anorexia, the psychological causes should not be forgotten. In fact, if the feeding pattern of the patient was observed at the beginning, unnecessary investigating and life threatening worsening of the condition could have been avoided.
Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. chaturaka.rodrigo@gmail.com
Chaturaka
C
Rodrigo
Thushani
T
Henegama
Raveen
R
Hanwella
D000328:Adult; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology* / Q000523:psychology; D013217:Starvation; D055815:Young Adult