Atypical de Clerambault Syndrome: A Case Report

　　　　　目的：情色妄想疾患一向被認定為極罕見的精神疾病，之前的文獻未曾有人提過飲食疾患患者有可能出現青色妄想疾患。病例報告：在本特殊的個案中，一位之前患有神經性厭食症的女性患者，在其母親的暗示下，發展出系統性的情色妄想。在個案和母親被隔離開，並接受了抗精神病藥物和支持性心理治療後，個案的妄想減弱而且逐漸恢復了她的功能及現實感。結論：神經性厭食症者的人格特質和孤立的生活使他們發展出特殊的精神病理。雖然在臨床上我們並不常見到這些罕見的症狀，在評估某些病患如飲食疾患患者時必須特別留意以免延誤了必須的治療。
　　　　　Objective: De Clerambault syndrome has been considered an uncommon psychiatric condition. We present an atypical case of de Clerambault syndrome and describe the diagnosis, etiology, course and treatment of this syndrome. Case Report: A 34 year-old woman with a history of anorexia nervosa was admitted due to de Clerambault syndrome. These delusional contents had originally been suggested by her mentally sound mother and then adopted and elaborated by the patient. Her mother further strengthened her delusion of reference as a way to facilitate communication with her and to control her behavior. After temporary separation from her pathological home environment and treatment with sulpiride and sulpiride and supportive psychotherapy, the intensity of her delusion decreased and her reality testing was significantly improved. Conclusion: To our knowledge, this is the first report of de Clerambault syndrome associated with eating disorders. Since this condition usually occurs in conjunction with other psychiatric disorders, clinicians tend to ignore is underlying psychopathology and optimal treatment may be hampered. Although infrequently encountered in practice of psychiatry today, it might occur not so rarely within certain populations, such as the anorectic patients. The psychodynamics of eating disorders make these patients vulnerable to various other psychiatric conditions and therefore require close follow-up.