A rare case of association of Anorexia Nervosa, Bipolar Disorder and Obsessive Compulsive Disorder in a female adolescent

The association of Anorexia Nervosa (AN), Bipolar Disorder (BD), and Obsessive-Compulsive Disorder (OCD) is extremely rare. The objective of this paper is to highlight the complex therapeutic approach and rich clinical presentation of the combination of the three disorders. We herein report a case of a 19 years old female adolescent with an unusual association of BD, OCD, and AN. The patient had several traumatic events in her childhood that contributed to the appearance of OCD, the first disorder. Later, the patient developed AN and BD. The patient made seven suicide attempts, the last one led her to our psychiatry care center. The patient was depressed with obsessional thoughts, and ritualistic behaviours, all of which met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) diagnostic criteria for AN, BD, and OCD. The wide range of treatment options available for the management of the three disorders separately showed to be insufficient to treat their association in our case. This article reveals the complex clinical presentation and challenging medical management of the association of OCD, AN, and BD and encourages future research to investigate the common pathophysiological basis of the three conditions.