Eating disorders, substance use disorders and multiple symptoms: three clinical vignettes

  • Graziella Fava VizzielloEmail author
  • Laura Bellin
Original Article
Part of the following topical collections:
  1. Food and Addiction



During the longitudinal study of three patients, referred to services at 3, 13, 15 years for eating disorders, reduced food intake and anorexia nervosa, other symptoms appeared depending on difficult development, relational and personality problems. The patients showed the interweaving of symptoms at different times: they were dealing with modified developmental needs and contexts, included new possibilities of attachment that might produce different internal organizations. These changes required different treatments. Anorexia started early in life for these girls, but presented different steps of organization. We wanted to start finding some aspects of a staging model to map the course of ED, because many patients arrived later in life, reported untreated early symptoms, actually personality traits. Mapping the evolution, could allow to take care of patients at the very early stage of problems when few symptoms are present, and better patients’ evolution might be possible.

Level of evidence

Level V opinions of respected authorities based on clinical experience.


Eating disorder Compulsive obsessional disorder Substance use disorder Depressive disorder Personality disorder 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Padua, via Venezia 8 PaduaItaly
  2. 2.Vicenza HospitalVicenzaItaly

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