Abstract
IntroductionAnorexia is common in the elderly, though anorexia nervosa affects mainly young people. Refusal to eat can be a symptom of underlying psychiatric illness, a means of control or a form of protest.MethodsWe report the case of Ms. H, a 69-year-old female with chronic paranoid schizophrenia and anorexic-restrictive eating. Ms. H required repeated admissions to a geriatric psychiatry inpatient service for paranoid delusions, refusal to eat or drink, social withdrawal, and muteness. Her refusal to eat in hospital once resulted in a 20 pound weight loss in 1 month. She required repeated transfers to the medical floor for complications due to anorexia and malnutrition. Mental Health Court considered a petition for involuntary PEG tube placement for Ms. H as part of her medication over objection order.ResultsThough the precise etiology of Ms. H's anorexia was unknown, she appeared to be making a voluntary decision not to eat and drink as a form of protest. Ms. H suffered a chronic relapsing course of paranoid schizophrenia and anorexic-restrictive eating.ConclusionsThis case highlights medical and psychiatric aspects of food refusal, as well as the need for diagnostic awareness regarding eating disorders in the elderly chronically mentally ill. IntroductionAnorexia is common in the elderly, though anorexia nervosa affects mainly young people. Refusal to eat can be a symptom of underlying psychiatric illness, a means of control or a form of protest. Anorexia is common in the elderly, though anorexia nervosa affects mainly young people. Refusal to eat can be a symptom of underlying psychiatric illness, a means of control or a form of protest. MethodsWe report the case of Ms. H, a 69-year-old female with chronic paranoid schizophrenia and anorexic-restrictive eating. Ms. H required repeated admissions to a geriatric psychiatry inpatient service for paranoid delusions, refusal to eat or drink, social withdrawal, and muteness. Her refusal to eat in hospital once resulted in a 20 pound weight loss in 1 month. She required repeated transfers to the medical floor for complications due to anorexia and malnutrition. Mental Health Court considered a petition for involuntary PEG tube placement for Ms. H as part of her medication over objection order. We report the case of Ms. H, a 69-year-old female with chronic paranoid schizophrenia and anorexic-restrictive eating. Ms. H required repeated admissions to a geriatric psychiatry inpatient service for paranoid delusions, refusal to eat or drink, social withdrawal, and muteness. Her refusal to eat in hospital once resulted in a 20 pound weight loss in 1 month. She required repeated transfers to the medical floor for complications due to anorexia and malnutrition. Mental Health Court considered a petition for involuntary PEG tube placement for Ms. H as part of her medication over objection order. ResultsThough the precise etiology of Ms. H's anorexia was unknown, she appeared to be making a voluntary decision not to eat and drink as a form of protest. Ms. H suffered a chronic relapsing course of paranoid schizophrenia and anorexic-restrictive eating. Though the precise etiology of Ms. H's anorexia was unknown, she appeared to be making a voluntary decision not to eat and drink as a form of protest. Ms. H suffered a chronic relapsing course of paranoid schizophrenia and anorexic-restrictive eating. ConclusionsThis case highlights medical and psychiatric aspects of food refusal, as well as the need for diagnostic awareness regarding eating disorders in the elderly chronically mentally ill. This case highlights medical and psychiatric aspects of food refusal, as well as the need for diagnostic awareness regarding eating disorders in the elderly chronically mentally ill.
Published Version
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