Neurobiological Correlates of Core Symptoms in Anorexia: Abnormal Spatiotemporal Structure in the Resting-State Activity and Troubles of the Self

The debate about the psychopathological nature of body dysmorphia and delusion-like thought in anorexia nervosa is still open. The intensity and the stability of the misperception of body shape and of the thought distortions related to weight gains which are present in many subjects affected with anorexia nervosa supports a parallelism between these symptoms and the psychotic symptoms which are expressed in subjects affected with schizophrenia or other major psychosis. Generally the body dysmorphism in anorectic subjects is considered a clearly distinct entity with respect to delusions in schizophrenic subjects even though it can reach delusional characteristics (Delsedime et al., 2011; Seeman, 2014) [1]. Nevertheless, recent studies on the phenomenological aspects of anorexia evidenced a certain overlap of the body dysmorphism in anorectic subjects with the delusional symptoms in psychosis (Mountjoy et al., 2014) [2]. These new evidences give room to a new conceptualization of dysmorphic symptoms in anorexia nervosa. Some authors argue that in the most severely disturbed anorectic subjects a possible deficit in the structure of the Self may be strictly related to a perception of the body with delusionary characteristics (Delsedime et al., 2013) [3]. It is thus possible that a common basis for the expression of the psychotic-like symptoms in anorexia nervosa and the psychotic symptoms in the major psychosis may reside in deficits related to the structure of the Self.