I enjoyed reading the first article in CMAJ's clinical nutrition series.1 Perhaps this was judged irrelevant in a clinical nutrition case, but I thought that psychological factors should have been considered in the case discussion. Why exactly was Mr. B. not eating? Why did his food not appeal to him? Surely there was more going on than an inability to reach his food. Mr. B. could very well have been suffering from clinical depression; if it were properly treated, his appetite would improve and his protein-energy malnutrition would be reversed.
Bruce Williams Staff Psychiatrist Youthdale Treatment Centres Toronto, Ont.
Reference
- 1.Hoffer LJ. Clinical nutrition: 1. Protein–energy malnutrition in the inpatient. CMAJ 2001;165 (10) : 1345-9. [PMC free article] [PubMed]