Psychogenic vomiting complicated by marijuana abuse and spontaneous pneumomediastinum

Aust N Z J Psychiatry. 1996 Apr;30(2):290-4. doi: 10.3109/00048679609076108.


Objective: This case illustrates an unusual physical sequel of psychogenic vomiting.

Clinical picture: A 22-year-old man with a picture of psychogenic vomiting and marijuana use developed the complications of a pneumomediastinum and subcutaneous emphysema.

Treatment: Therapy included gradual exposure to anxiety provoking stimuli, psychotropics to reduce vomiting and psychotherapeutic exploration of family relationships.

Outcome: The patient's vomiting and physical state resolved without complication. Follow-up at 12 months revealed continued improvement with occasional less severe vomiting.

Conclusions: Psychogenic vomiting as a manifestation of anxiety can result in serious physical and psychological sequelae. This patient's desperate attempts to control such vomiting complicated the picture. Successful short term intervention included the use of several treatment modalities.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Combined Modality Therapy
  • Humans
  • Internal-External Control
  • Male
  • Marijuana Abuse / complications*
  • Marijuana Abuse / psychology
  • Marijuana Abuse / rehabilitation
  • Mediastinal Emphysema / etiology*
  • Mediastinal Emphysema / psychology
  • Mediastinal Emphysema / therapy
  • Mother-Child Relations
  • Nausea / complications
  • Nausea / psychology
  • Nausea / therapy
  • Patient Care Team
  • Personality Development
  • Psychophysiologic Disorders / complications*
  • Psychophysiologic Disorders / psychology
  • Psychophysiologic Disorders / therapy
  • Subcutaneous Emphysema / etiology*
  • Subcutaneous Emphysema / psychology
  • Subcutaneous Emphysema / therapy
  • Vomiting / complications*
  • Vomiting / psychology
  • Vomiting / therapy