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Clinical, psychopathological, and biological predictors of resumption of menses in subjects with anorexia nervosa: A 4-year follow-up study

Published online by Cambridge University Press:  13 August 2021

E. Rossi ,
E. Cassioli ,
G. Castellini ,
L. Giardinelli ,
A. Fanelli ,
A. Fisher ,
L. Vignozzi  and
V. Ricca
E. Rossi*
Affiliation:
Psychiatry Unit, Department Of Health Sciences, University of Florence, Florence, Italy
E. Cassioli
Affiliation:
Psychiatry Unit, Department Of Health Sciences, University of Florence, Florence, Italy
G. Castellini
Affiliation:
Psychiatry Unit, Department Of Health Sciences, University of Florence, Florence, Italy
L. Giardinelli
Affiliation:
Psychiatry Unit, Department Of Health Sciences, University of Florence, Florence, Italy
A. Fanelli
Affiliation:
Central Laboratory, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
A. Fisher
Affiliation:
Andrology, Women’s Endocrinology And Gender Incongruence Unit, Department Of Experimental, Clinical, And Biomedical Sciences, University of Florence, Florence, Italy
L. Vignozzi
Affiliation:
Andrology, Women’s Endocrinology And Gender Incongruence Unit, Department Of Experimental, Clinical, And Biomedical Sciences, University of Florence, Florence, Italy
V. Ricca
Affiliation:
Psychiatry Unit, Department Of Health Sciences, University of Florence, Florence, Italy
*
*Corresponding author.

Abstract

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Introduction

Amenorrhea is one of the most frequent and serious consequences of Anorexia Nervosa (AN). Resumption of menses (ROM) is considered an important goal and is associated with a better outcome.

Objectives

To investigate the role of age, Body Mass Index (BMI), diagnostic subtype (restrictive vs binge-purging), history of childhood abuse, duration of illness, psychopathology and sex hormones on ROM in AN.

Methods

52 patients with AN and amenorrhea were enrolled at the start of treatment. Clinical parameters of interest were collected, and questionnaires were administered for the assessment of general (SCL-90-R) and specific (EDE-Q) psychopathology. Blood samples were taken to assess FSH, LH and estradiol levels. All patients were monitored regularly through psychiatric checkups until ROM, for up to four years.

Results

A total of 30 (57.7%) subjects recovered their menstrual cycle in the follow-up period (mean time: 18.7 ± 14.8 months). Recovery was more frequent in the binge-purging subtype than in the restrictive subtype (82.4% vs 48.6%, p=0.019), and was significantly associated with diagnostic crossover (odds ratio=10.0, p=0.032). Multivariate Cox regression showed an increased likelihood of menstrual recovery for binge-purging subtype (p=0.005) and for those reporting a history of childhood abuse (p=0.025). Early ROM was also associated with baseline SCL-90-R scores (p=0.002) and FSH (p=0.011), while a longer duration of illness (p=0.003) and EDE-Q scores (p=0.009) predicted a later recovery.

Conclusions

This study highlights the role of duration of illness, childhood abuse history and psychopathological characteristics in subjects with AN at the start of treatment in predicting ROM.

Disclosure

No significant relationships.

Keywords

anorexia nervosaAmenorrhearesumption of menseschildhood abuse
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S116
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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