Schizotypal Disorder with Comorbid Somatization Disorder and Atypical Anorexia Nervosa

Abstract

Schizotypal disorder is marked by pervasive social and interpersonal deficits, cognitive-perceptual distortions, and eccentric behaviors, often co-occurring with other psychiatric conditions. This case report presents a rare instance of schizotypal disorder comorbid with atypical anorexia nervosa and somatization disorder in a 19-year-old female. The patient, Ms. V, exhibited complex symptomatology including social withdrawal, odd beliefs, somatic complaints, and restrictive eating behaviors. Despite extensive medical investigations, her physical symptoms remained unexplained, leading to a psychiatric evaluation. She was diagnosed with schizotypal disorder, atypical anorexia nervosa, and somatization disorder per the International Classification of Diseases, Tenth Revision criteria. Initial treatment with risperidone was poorly tolerated, but she showed significant improvement with olanzapine, fluoxetine, and cognitive-behavioral therapy, resulting in better functioning and reduced somatic preoccupation. This case underscores the challenges of diagnosing and treating comorbid psychiatric disorders, particularly when presentations are atypical. A multidisciplinary approach proved essential for Ms. V’s recovery, offering insights into the management of complex psychiatric comorbidities.