Co-occurring eating disorder and psychosis: a lived experience case exploration with examples and suggestions for personalized integrated treatment approach

Disordered eating or eating disorders (ED) and psychosis commonly co-occur and have a degree of overlap, however there are no current clinical guidelines or comprehensive clinical guidance for integrated treatment. This lived experience case offers insight into symptom cross-over, perception and beliefs that may occur in coexisting ED and psychosis (i.e., eating disorder voice, psychotic voice-hearing, delusional beliefs about food, eating disorder-driven overvalued beliefs about eating/the body, body image disturbance, depersonalization, derealization). The detailed examples within this case highlight helpful treatment approaches to support trust and safety in care and prevent patient deterioration in co-occurring diagnosis of longstanding anorexia nervosa, schizoaffective disorder and trauma/PTSD. Lived experience involvement in research and clinical guidance development is needed in order to further understanding of co-occurring conditions such as ED, psychosis and trauma, to improve shared decision-making, and treatment personalization.