Comorbidity between psychosis and eating disorders: a systematic review

Abstract Background Comorbidity has been reported between eating disorders and psychotic illnesses such as schizophrenia, and several hypotheses regarding their relationship have been proposed. Therefore, we aimed to systematically review studies involving patients who are affected by both psychotic...

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Main Authors: Oliver Rumle Hovmand, Linda Lloyd Hughes, Celeste Mary Egtved, Sidse M. Arnfred
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Journal of Eating Disorders
Online Access:https://doi.org/10.1186/s40337-025-01257-3
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author Oliver Rumle Hovmand
Linda Lloyd Hughes
Celeste Mary Egtved
Sidse M. Arnfred
author_facet Oliver Rumle Hovmand
Linda Lloyd Hughes
Celeste Mary Egtved
Sidse M. Arnfred
author_sort Oliver Rumle Hovmand
collection DOAJ
description Abstract Background Comorbidity has been reported between eating disorders and psychotic illnesses such as schizophrenia, and several hypotheses regarding their relationship have been proposed. Therefore, we aimed to systematically review studies involving patients who are affected by both psychotic symptoms and eating disorders (ED). Method We systematically searched three databases for all studies describing psychotic symptoms among patients diagnosed with eating disorders. We conducted and reported the systematic review following the PRISMA statement. Results We included 67 publications, of which 41 were case reports and 26 were descriptive studies. Most of the included studies described transient psychotic symptoms among individuals with ED or suggested comorbidity between schizophrenia and anorexia nervosa. Discussion The included studies were highly heterogeneous. The review suggests at least three different patterns of psychopathology: 1) patients with anorexia nervosa who experience transient psychotic symptoms in correlation with severe mental or physical stress; 2) patients suffering from comorbid schizophrenia and anorexia nervosa and fulfilling diagnostic criteria for both diagnoses; and 3) patients with psychotic illness who are experiencing disordered eating as part of their psychotic illness, but do not fulfill diagnostic criteria for it. Future research could conduct psychopathological follow-up on patients enrolled in treatment for these conditions.
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spelling doaj-art-75d71e603d6b41239ce68037f7ea2a602025-08-20T01:47:33ZengBMCJournal of Eating Disorders2050-29742025-05-0113111110.1186/s40337-025-01257-3Comorbidity between psychosis and eating disorders: a systematic reviewOliver Rumle Hovmand0Linda Lloyd Hughes1Celeste Mary EgtvedSidse M. Arnfred2Psychiatric Research Unit, Region Zealand Mental Health ServiceCenter for Eating and Feeding Disorders Research, Mental Health Center Ballerup, Copenhagen University Hospital—Mental Health Services CPHPsychiatric Research Unit, Region Zealand Mental Health ServiceAbstract Background Comorbidity has been reported between eating disorders and psychotic illnesses such as schizophrenia, and several hypotheses regarding their relationship have been proposed. Therefore, we aimed to systematically review studies involving patients who are affected by both psychotic symptoms and eating disorders (ED). Method We systematically searched three databases for all studies describing psychotic symptoms among patients diagnosed with eating disorders. We conducted and reported the systematic review following the PRISMA statement. Results We included 67 publications, of which 41 were case reports and 26 were descriptive studies. Most of the included studies described transient psychotic symptoms among individuals with ED or suggested comorbidity between schizophrenia and anorexia nervosa. Discussion The included studies were highly heterogeneous. The review suggests at least three different patterns of psychopathology: 1) patients with anorexia nervosa who experience transient psychotic symptoms in correlation with severe mental or physical stress; 2) patients suffering from comorbid schizophrenia and anorexia nervosa and fulfilling diagnostic criteria for both diagnoses; and 3) patients with psychotic illness who are experiencing disordered eating as part of their psychotic illness, but do not fulfill diagnostic criteria for it. Future research could conduct psychopathological follow-up on patients enrolled in treatment for these conditions.https://doi.org/10.1186/s40337-025-01257-3
spellingShingle Oliver Rumle Hovmand
Linda Lloyd Hughes
Celeste Mary Egtved
Sidse M. Arnfred
Comorbidity between psychosis and eating disorders: a systematic review
Journal of Eating Disorders
title Comorbidity between psychosis and eating disorders: a systematic review
title_full Comorbidity between psychosis and eating disorders: a systematic review
title_fullStr Comorbidity between psychosis and eating disorders: a systematic review
title_full_unstemmed Comorbidity between psychosis and eating disorders: a systematic review
title_short Comorbidity between psychosis and eating disorders: a systematic review
title_sort comorbidity between psychosis and eating disorders a systematic review
url https://doi.org/10.1186/s40337-025-01257-3
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AT celestemaryegtved comorbiditybetweenpsychosisandeatingdisordersasystematicreview
AT sidsemarnfred comorbiditybetweenpsychosisandeatingdisordersasystematicreview