Psychogenic vomiting: report of two cases

Two patients were admitted to our hospital with the diagnosis of psychogenic vomiting of more than 9 months' duration. Both were treated with a combination of pharmacotherapy, relaxation training, cognitive therapy and supportive psychotherapy. Behavioral therapy and verbal catharsis were also used in one of the cases involving bereavement. The intervention was not directly aimed at the vomiting, but at the aspects of the patients' stress and emotional problems. Change in condition was assessed on basis of the frequency of vomiting and the severity of anxiety and depression. Vomiting was found to be positively related to anxiety but not to depression. These 2 patients improved to the extent that the disturbance caused by vomiting was significantly reduced, and the reduction was closely related to the severity of anxiety. Both were also found to have similar personality traits and family types, which have been reported to be related to psychogenic vomiting. We review the characteristics of psychogenic vomiting and relate some important considerations for treating Chinese psychogenic vomiting cases.