Psychogenic Vomiting

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Abstract
This paper reports on the clinical picture of the psychophysiologic disorder of psychogenic vomiting. This term is applied when it is the result of an emotional upset or of a more profound psychic disturbance, and only after no organic pathology was found. Especial emphasis is placed on the careful evaluation of various characteristics of the presenting symptom, i.e., accompanying manifestations, duration, time of day in which it occurs, stressing events related to the vomiting episode, patients’ motivation for psychiatric treatment, their ability to introspect, to verbalize their problems and emotions and their expectations from treatment. Since every variety of personality and every psychiatric disorder may show functional vomiting as a manifestation, the vomiting must be appraised in the context of a complete diagnostic work-up. Treatment will be different according to the various factors considered. For patients who principally present this psychophysiologic disorder, special psychotherapeutic tactics are suggested. The adherence to the tenet ‘treat the symptom, and the person as a whole will benefit’ is useful. The symptom is viewed as the fundamental step to develop the doctor-patient relationship. Special work is done in enabling the patient to become aware of his feelings, and to acknowledge the relationship between the emotions and the physical dysfunction. Clinical examples are described.

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