Abstract
The present study dealt with the relationship between the physical findings and the psychic conditions of young patients with anorexia nervosa or bulimia. Our 15 subjects were all over 13 years of age (4 males and 11 females). The anorexia nervosa patients were divided into two subtypes, i. e. the typical type and the atypical type according to the clinical diagnostic criteria which Suematsu et al. offered. The psychic conditions were assessed by clinical data and psychological tests such as the Sentence Completion Test(SCT) and the Manifest Anxiety Scale (MAS). Four female patients showed the typical type of anorexia nervosa and their psychic conditions were similar to alexithymia in all cases according to clinical examinations and the psychological tests. That is, they were not aware of their own disease displaying inconspicuous conflicts in the SCT and/or manifesting less anxiety on the MAS. Also, 6 patients (3 males and 3 females) showed the atypical type of anorexia nervosa and 5 (1 male and 4 females) Showed bulimia. Their psychic conditions differed from the former group showing a state of anxiety neurosis more frequently. That is, they were very anxious about their condition showing conspicuous conflicts and/or considerable manifest anxiety. Among the atypical cases of anorexia nervosa, one young female patient who had a transient delusional period while she was in a state of severe emaciation was diagnosed as a borderline case rather than a neurotic case. These results suggest that the SCT are useful for distinguishing a state of alexithymia in the patients with eating disorders. In general, it may be said that the typical type of anorexia nervosa patients belong to PSD as their condition is a state of alexithymia, whereas the atypical type can be considered neurosis or borderline as their condition is a state of anxiety rather than alexithymia. In addition, we suggested a three-scale classification of anorexia nervosa, i. e. 1) typical type, 2) atypical type and, 3) borderline type, modifying the diagnostic criteria which Suematsu et al. proposed.
