Disordered eating: a defense against psychosis?

The authors present four cases suffering with either bulimia nervosa or anorexia nervosa in conjunction with a psychotic illness. In all cases there appeared to be a reciprocal relationship between the eating disorder and psychosis such that improvement in eating precipitated or exacerbated the psychotic symptoms. We suggest that disordered eating serves as a defense against psychosis. Difficulties in treating such patients are discussed.