Resumption of menses in anorexia nervosa during a course of family-based treatment

Journal of Eating Disorders

Daniel Le Grange³  Debra K Katzman⁴  Katharine L Loeb¹  Melanie Brown¹  Catherine Glunz²  Kristen E Anderson³  Andrea B Goldschmidt³  Julianne P Faust⁴ 

[1] School of Psychology, Fairleigh Dickinson University, Teaneck, NJ, USA;Department of Pediatrics, The University of Chicago, Chicago, IL, USA;Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Ave., MC3077, Chicago, IL, 60637, USA;Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Canada

关键词: Family-based treatment;    Adolescent anorexia nervosa;    Return of menses;   

Others  :  802842
DOI  :  10.1186/2050-2974-1-12

 received in 2012-10-23, accepted in 2013-01-12,  发布年份 2013

【 摘 要 】

Background

The resumption of menses (ROM) is considered an important clinical marker in weight restoration for patients with anorexia nervosa (AN). The purpose of this study was to examine ROM in relation to expected body weight (EBW) and psychosocial markers in adolescents with AN.

Methods

We conducted a retrospective chart review at The University of Chicago Eating Disorders Program from September 2001 to September 2011 (N = 225 females with AN). Eighty-four adolescents (Mean age = 15.1, SD = 2.2) with a DSM-IV diagnosis of AN, presenting with secondary amenorrhea were identified. All participants had received a course of outpatient family-based treatment (FBT), i.e., ~20 sessions over 12 months. Weight and menstrual status were tracked at each therapy session throughout treatment. The primary outcome measures were weight (percent of expected for sex, age and height), and ROM.

Results

Mean percent EBW at baseline was 82.0 (SD = 6.5). ROM was reported by 67.9% of participants (57/84), on average at 94.9 (SD = 9.3) percent EBW, and after having completed an average of 13.5 (SD = 10.7) FBT sessions (~70% of standard FBT). Compared to participants without ROM by treatment completion, those with ROM had significantly higher baseline Eating Disorder Examination Global scores (p = .004) as well as Shape Concern (p < .008) and Restraint (p < .002) subscale scores. No other differences were found.

Conclusions

Results suggest that ROM occur at weights close to the reference norms for percent EBW, and that high pre-treatment eating disorder psychopathology is associated with ROM. Future research will be important to better understand these differences and their implications for the treatment of adolescents with AN.

【 授权许可】

   
2013Faust et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Golden NH, Jacobson MS, Sterling WM, Hertz S: Treatment goal weight in adolescents with anorexia nervosa: use of BMI percentiles. Int J Eat Disord 2008, 41:301-306.
• [2]Katzman DK, Findlay SM: Medical issues unique to children and adolescents. In Eating disorders in children and adolescents: A clinical handbook. Edited by Le Grange D, Lock J. New York, NY US: Guilford Press; 2011:137-155.
• [3]Swenne I: Weight requirements for return of menstruations in teenage girls with eating disorders, weight loss and secondary amenorrhoea. Acta Paediatrica 2004, 93:1449-1455.
• [4]Herzog DB, Nussbaum KM, Marmor AK: Comorbidity and outcome in eating disorders. Psych Clinics North America 1996, 19:843-859.
• [5]Godart NT, Flament MF, Perdereau F, Jeammet P: Comorbidity between eating disorders and anxiety disorders: a review. Int J Eating Disord 2002, 32:253-270.
• [6]Couturier J, Lock J: What is recovery in adolescent anorexia nervosa? Int J Eat Disord 2006, 39:550-555.
• [7]Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR: Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Arch Gen Psych 2011, 68:714-723.
• [8]Golden NH, Katzman DK, Kreipe RE, Stevens SL, Sawyer SM, Rees J, Nicholls D, Rome ES, Society For Adolescent M: Eating disorders in adolescents: position paper of the Society for Adolescent Medicine. J Adol Health 2003, 33:496-503.
• [9]American Psychiatric A, American Psychiatric Association: Task Force on D-I. Washington, DC: American Psychiatric Association; 2000. [Diagnostic and statistical manual of mental disorders: DSM-IV-TR]
• [10]Roberto CA, Steinglass J, Mayer LE, Attia E, Walsh BT: The clinical significance of amenorrhea as a diagnostic criterion for anorexia nervosa. Int J Eat Disorders 2008, 41:559-563.
• [11]Diaz A, Laufer MR, Breech LL, American Academy of Pediatrics Committee on A, American College of O, Gynecologists Committee on Adolescent Health C: Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics 2006, 118:2245-2250.
• [12]Abraham SF, Pettigrew B, Boyd C, Russell J, Taylor A: Usefulness of amenorrhoea in the diagnoses of eating disorder patients. J Psychosomatic Obst Gyn 2005, 26:211-215.
• [13]Popat VB, Prodanov T, Calis KA, Nelson LM: The menstrual cycle: a biological marker of general health in adolescents. Annals New York Acad Sciences 2008, 1135:43-51.
• [14]Chui HT, Christensen BK, Zipursky RB, Richards BA, Hanratty MK, Kabani NJ, Mikulis DJ, Katzman DK: Cognitive function and brain structure in females with a history of adolescent-onset anorexia nervosa. Pediatrics 2008, 122:e426-e437.
• [15]Katzman DK: Medical complications in adolescents with anorexia nervosa: a review of the literature. Int J Eat Disord 2005, 37(Suppl):S52-S59. discussion S87-59
• [16]Deligeoroglou E, Athanasopoulos N, Tsimaris P, Dimopoulos KD, Vrachnis N, Creatsas G: Evaluation and management of adolescent amenorrhea. Annals New York Acad Sciences 2010, 1205:23-32.
• [17]Bachrach LK, Guido D, Katzman D, Litt IF, Marcus R: Decreased bone density in adolescent girls with anorexia nervosa. Pediatrics 1990, 86:440-447.
• [18]Swenne I: Weight and growth requirements for menarche in teenage girls with eating disorders, weight loss and primary amenorrhea. Horm Res 2008, 69:146-151.
• [19]Misra M, Prabhakaran R, Miller KK, Goldstein MA, Mickley D, Clauss L, Lockhart P, Cord J, Herzog DB, Katzman DK, Klibanski A: Weight gain and restoration of menses as predictors of bone mineral density change in adolescent girls with anorexia nervosa-1. J Clin Endocr Metab 2008, 93:1231-1237.
• [20]Miller KK, Lee EE, Lawson EA, Misra M, Minihan J, Grinspoon SK, Gleysteen S, Mickley D, Herzog D, Klibanski A: Determinants of skeletal loss and recovery in anorexia nervosa. J Clin Endocr Metab 2006, 91:2931-2937.
• [21]Silber TJ: Resumption of menses in anorexia nervosa. New research findings and their clinical implications. Arch Ped Adoles Med 1997, 151:14-15.
• [22]Swenne I, Stridsberg M, Thurfjell B, Rosling A: Triiodothyronine is an indicator of nutritional status in adolescent girls with eating disorders. Horm Res 2009, 71:268-275.
• [23]Golden NH, Jacobson MS, Schebendach J, Solanto MV, Hertz SM, Shenker IR: Resumption of menses in anorexia nervosa. Arch Ped Adolesc Med 1997, 151:16-21.
• [24]Lock J, Le Grange D: Treatment manual for anorexia nervosa: A family-based approach. 2nd edition. New York, NY US: Guilford Press; 2012.
• [25]Della Grave R, Calugi S, Marchesini G: Is amenorrhea a clinically useful criterion for the diagnosis of anorexia nervosa? Beh Res Therapy 2008, 46:1290-1294.
• [26]Bravender T, Bryant-Waugh R, Herzog D, Katzman D, Kriepe RD, Lask B, Le Grange D, Lock J, Loeb KL, Marcus MD, Madden S, Nicholls D, O’Toole J, Pinhas L, Rome E, Sokol-Burger M, Wallin U, Zucker N: Classification of eating disturbance in children and adolescents: proposed changes for the DSM-V. Eu Eat Disord Rev 2010, 18:79-89.
• [27]Peebles R, Wilson JL, Lock JD: How do children with eating disorders differ from adolescents with eating disorders at initial evaluation? J Adolesc Health 2006, 39:800-805.
• [28]Nicholls D, Wells JC, Singhal A, Stanhope R: Body composition in early onset eating disorders. Eur J Clin Nutr 2002, 56:857-865.
• [29]Shah B, Sucher K, Hollenbeck CB: Comparison of ideal body weight equations and published height-weight tables with body mass index tables for healthy adults in the United States. Nutr Clin Prac 2006, 21:312-319.
• [30]Le Grange D, Doyle PM, Swanson SA, Ludwig K, Glunz C, Kreipe RE: Calculation of expected body weight in adolescents with eating disorders. Pediatrics 2012, 129:e438-e446.
• [31]National center for health statistics: Percentile data files with LMS values. http://www.cdc.gov/growthcharts/percentile_data_files.htm webcite
• [32]Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF, Johnson CL: CDC growth charts: United States. Advance Data 2000, 1-27.
• [33]Fairburn CG, Cooper Z: The Eating Disorder Examination. In Binge eating: Nature, assessment, and treatment. 12th edition. Edited by Fairburn CG, Wilson GT. New York, NY US: Guilford Press; 1993:317-360.
• [34]Lock J, Le Grange D, Agras WS, Moye A, Bryson SW, Jo B: Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psych 2010, 67:1025-1032.
• [35]Lai KY, de Bruyn R, Lask B, Bryant-Waugh R, Hankins M: Use of pelvic ultrasound to monitor ovarian and uterine maturity in childhood onset anorexia nervosa. Arch Dis Childhood 1994, 71:228-231.
• [36]Miller KK, Grinspoon S, Gleysteen S, Grieco KA, Ciampa J, Breu J, Herzog DB, Klibanski A: Preservation of neuroendocrine control of reproductive function despite severe undernutrition. J Clinical Endocr Metab 2004, 89:4434-4438.
• [37]Schebendach J, Mayer LE, Devlin MJ, Attia E, Walsh BT: Dietary energy density and diet variety as risk factors for relapse in anorexia nervosa: a replication. Int J Eat Disord 2012, 45:79-84.
• [38]Pike KM: Long-term course of anorexia nervosa: response, relapse, remission, and recovery. Clin Psychol Rev 1998, 18:447-475.
• [39]Le Grange D, Lock J, Agras WS, Moye A, Bryson SW, Jo B, Kraemer HC: Moderators and mediators of remission in family-based treatment and adolescent focused therapy for anorexia nervosa. Behav Res Ther 2012, 50:85-92.
• [40]van Hooff MH, Voorhorst FJ, Kaptein MB, Hirasing RA, Koppenaal C, Schoemaker J: Relationship of the menstrual cycle pattern in 14–17 year old old adolescents with gynaecological age, body mass index and historical parameters. Hum Reprod 1998, 13:2252-2260.
• [41]Iketani T, Kiriike N, Nakanishi S, Nakasuji T: Effects of weight gain and resumption of menses on reduced bone density in patients with anorexia nervosa. Biol Psych 1995, 37:521-527.