Amenorrhea: Not a Good
Gauge of Prognosis
An unstable symptom that can't be
relied upon as a gauge of illness
Amenorrhea
can't be used to predict the severity of an eating disorder and has
little prognostic value in patients with eating disorders, according to a
group of researchers at the University of Turin's Eating Disorders
Center, Turin, Italy.
Dr. Giovanni Abbate-Daga and colleagues studied 184 outpatients with
eating disorders to gain longitudinal data about amenorrhea . A group of 184 outpatients were recruited:
50 with AN restrictive type, 75 amenorrheic eating disorder not
otherwise specified patients, 24 patients recovered from AN but
with persistent amenorrhea, and 35 amenorrheic patients without
histories of eating disorders. All participants were clinically assessed
by psychiatrists and gynecologists at the beginning of treatment and at
one-year follow-up. The participants also completed several
psychometric tests, including the Eating Disorder Inventory-2,
Temperament and Character Inventory, and the Beck Depression Inventory.
After treatment for their eating disorder was completed, a large
portion of the women resumed menses, but very few recovered completely
from their eating disorder. Results from the psychometric tests did not
provide any predictions about recovery of menses in the different
groups; however, body mass index and some biological variables were
associated with restoration of menses in patients with eating disorders.
Dr. Abbate-Daga and colleagues reported that the resumption of menses
was neither associated with less severe eating disorder symptoms at the
beginning of treatment nor with unequivocal psychopathological changes
after treatment. The authors stress that clinicians consider not only
the presence or absence of regular menses but also that they improve
screening for underlying eating disorders and assessment of amenorrheic
patients.