Abstract
A seventeen year old female had developed severe emaciation, purpura and altered level of consciousness due to dietary deprivation for 3 months prior to admission. Pancytopenia and pneumonia were also pointed out by further clinical examinations. Intravenous hyperalimentation (IVH), antibiotics injection and blood transfusion were not effective, thus 75 /μg/day of human recombinant granulocyte colony-stimulating factor (GCSF) was administered for 4 days continuously. At the 20 th hospital day, pancytopenia and airway infection improved and body mass index (BMD increa_sed to 16.7 from 10.5. But two months after discharge, she was admitted again due to dyspnea and drowsiness. She wanted psychotherapy by a clinical psychotherapist in the intensive care unit in which Heimlich valve method and steroid therapy were performed for reexpansion pulmonary edema following pneumothorax. Then bedside session was performed 1 hour/day, based on non-verbal approaching theory. After the above combined intensive care for 4 weeks, she was discharged and an alliance was built up successfully between therapists and her. Such intensive psychosomatic care was thought to be effective for initiating continuous outclinic management of a case with anorexia nervosa who had no clear insight into her illness.
