RESUMO
Phagophobia is a disorder characterized by a conditioned excessive fear of eating and is initiated by an event such as vomiting or choking. During childhood, vomiting often occurs as a result of infection or overeating, and painful experiences bring about maladaptive eating behavior like food refusal. There have been few reports of phagophobia, and patients have sometimes been misdiagnosed with anorexia nervosa (AN). The objective of this study was to elucidate the psycho-pathology and current treatment of patients with phagophobia by analyzing case studies. We describe 6 cases with phagophobia. Patients with strong obsessions were refractory to treatment, indicating that evaluation of premorbid personality is crucial to the prognosis. It is important to classify this disorder according to psycho-pathology into "post-traumatic type" and "gain-from-illness type" to make a treatment plan. A solution focused approach is also effective for patients and their family. Paying close attention to these conditions and to the diagnostic concept referred as "hagophobia" is useful in achieving these aims.
Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Transtornos Fóbicos/psicologia , Transtornos Fóbicos/terapia , Psicopatologia/métodos , Adolescente , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/psicologia , Obstrução das Vias Respiratórias/terapia , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/psicologia , Criança , Pré-Escolar , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/psicologia , Transtornos de Deglutição/terapia , Diagnóstico Diferencial , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Feminino , Humanos , Masculino , Transtornos Fóbicos/diagnóstico , Prognóstico , Psicoterapia/métodos , Vômito/etiologia , Vômito/psicologia , Vômito/terapiaRESUMO
Self-esteem is the evaluative feelings one holds for oneself and the sense that one has essential worth. It is evaluated as the difference between the actual self and the ideal self. Healthy self-esteem supports psychological stability and positive social activity and is an essential element in the psychological development of children. The purpose of this study was to evaluate self-esteem in children with psychosomatic symptoms and elucidate a strategy for using such evaluations in therapy. We evaluated self-esteem in 56 patients at the Department of Pediatrics of Okayama University Hospital who were undergoing outpatient therapy for psychosomatic symptoms, using Pope's 5-scale test of self-esteem for children. We examined patient attributes, course of therapy, and social adjustment. Patients with low self-esteem on multiple scales at the first visit were all female, and these patients had a significantly higher frequency of family function problems, such as a family member with a psychiatric disorder, economic hardship, or experience of child abuse. Moreover, the prognosis for these patients was poor regardless of their social adjustment at the first visit.
