A 21-year-old girl complained of frequent vomitting and loss of weight. She had repeated overeating and vomitting since she was 17 years old, and had reduced weight from 52 kg to 32 kg.When she was adminitted to our hospital for the first time, the diagnosis of anorexia nervosa was given without much suspicion.On psychological examination, she wa found to be a hysterical character(dissociation reaction type).She improved in less than 3 months without any special therapy.Soon after discharge, however, her symptom developed again so that she was admitted for the second time and an abdominal X-ray examination confirmed an acute gastric dilatation just before her vomitting took place.Brief psychotherapy with major tranquilizer proved a satisfactory management at this time.
