Should Amenorrhoea be Necessary for the Diagnosis of Anorexia Nervosa?: Evidence from a Canadian Community Sample
Abstract
Background: This study compares the characteristics of women with anorexia nervosa with those of women who have all the diagnostic features of that disorder except amenorrhoea. Method: The study uses data from a large community epidemiological survey of the mental health status of household residents in Ontario, Canada. A multi-stage stratified sampling design generated a sample of 4285 females aged 15–64. DSM–III–R diagnoses were made using the Composite International Diagnostic Interview. Results: Eighty-four out of 4285 female respondents met full or partial-syndrome criteria for anorexia nervosa. Comparison of these two groups revealed few statistically significant differences in terms of demographics, psychiatric comorbidity, family history or early experiences. Conclusions: Amenorrhoea did not discriminate between women with anorexia nervosa and women with all the features except amenorrhoea across a number of relevant variables. The authors question the utility of amenorrhoea as a diagnostic criterion.
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The observed prevalence estimates were generally similar to those of previous studies.
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From Prevalence and Correlates of Eating Disorders in Adolescents: Results From the National Comorbidity Survey Replication Adolescent Supplement (2011) · cites this paper as [3]
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Endocrine Effects of Anorexia Nervosa
Miller, K. K. (2013) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2013.05.007 · Cited by 38 · see citing works
Larrañaga, A., Docet, M. F., & García-Mayor, R. V. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0473-1 · Cited by 33 · see citing works
Trastornos de la conducta alimentaria en adolescentes: descripción y manejo
Carolina, L. G., & Janet, T. (2011) · Revista Médica Clínica Las Condes · doi:10.1016/s0716-8640(11)70396-0 · Cited by 31 · see citing works
Body mass index, body fat and risk factor of relapse in anorexia nervosa
Ghoch, M. E., Calugi, S., Chignola, E., Bazzani, P. V., & Grave, R. D. (2015) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2015.164 · Cited by 31 · see citing works
On the uses of history in psychiatry: Diagnostic implications for anorexia nervosa
Habermas, T. (2005) · International Journal of Eating Disorders · doi:10.1002/eat.20159 · Cited by 30 · see citing works
Disordered Eating in Jewish Adolescent Girls
Pinhas, L., Heinmaa, M., Bryden, P., Bradley, S. J., & Toner, B. B. (2008) · The Canadian Journal of Psychiatry · doi:10.1177/070674370805300907 · Cited by 28 · see citing works
Calderon, R., Stoep, A. V., Collett, B. R., Garrison, M. M., & Toth, K. (2007) · International Journal of Eating Disorders · doi:10.1002/eat.20411 · Cited by 28 · see citing works
What are we missing? The costs versus benefits of skip rule designs
Swanson, S. A., Brown, T. A., Crosby, R. D., & Keel, P. K. (2013) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1396 · Cited by 28 · see citing works
The road less traveled: Associations between externalizing behaviors and eating pathology
Slane, J. D., Burt, S. A., & Klump, K. L. (2009) · International Journal of Eating Disorders · doi:10.1002/eat.20680 · Cited by 27 · see citing works
McVey, G. L., Davis, R., Kaplan, A. S., Katzman, D. K., Pinhas, L., Geist, R., Heinmaa, M., & Forsyth, G. (2005) · International Journal of Eating Disorders · doi:10.1002/eat.20114 · Cited by 26 · see citing works
Self-citationMaguire, S., Touyz, S. W., Surgenor, L. J., Crosby, R. D., Engel, S. G., Lacey, H., Heywood‐Everett, S., & Grange, D. L. (2011) · International Journal of Eating Disorders · doi:10.1002/eat.20951 · Cited by 26 · see citing works
Szumska, I., Túry, F., Csoboth, C. T., Réthelyi, J., Purebl, G., & Hajnal, Á. (2005) · European Eating Disorders Review · doi:10.1002/erv.633 · Cited by 26 · see citing works
What next for eating disorder genetics? Replacing myths with facts to sharpen our understanding
Huckins, L. M., Signer, R. H., Johnson, J., Wu, Y., Mitchell, K. S., & Bulik, C. M. (2022) · Molecular Psychiatry · doi:10.1038/s41380-022-01601-y · Cited by 26 · see citing works
Oestrogen: an overlooked mediator in the neuropsychopharmacology of treatment response?
Keating, C., Tilbrook, A. J., & Kulkarni, J. (2010) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145710000982 · Cited by 23 · see citing works
Developing a model of nutritional amenorrhea in rhesus monkeys.
Lujan, M. E., Krzemień, A., Reid, R., & van Vugt, D. V. (2006) · Endocrinology · doi:10.1210/en.2005-0821 · Cited by 23 · see citing works
Fluoxetine After Weight Restoration in Anorexia Nervosa: A Randomized Controlled Trial
Walsh, B. T., Kaplan, A. S., Attia, E., Olmsted, M., Parides, M., Carter, J. C., Pike, K. M., Devlin, M. J., Woodside, B., Roberto, C. A., et al. (2006) · JAMA · doi:10.1001/jama.295.22.2605 · Cited by 13 · see citing works
Self-citation
- Authors
- Garfinkel, P. E., Lin, E., Goering, P., Spegg, C., Goldbloom, D., Kennedy, S., Kaplan, A. S., & Woodside, D. B.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Garfinkel, Paul E.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 1996-04
- Volume
- 168
- Issue
- 4
- Pages
- 500-506
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W1982195602
- Cited by
- 175
- References
- 20
- Citations by year
- 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2019: 1 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 6 · 2013: 6 · 2012: 8
- FWCI
- 3.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- McMaster University
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- anorexia nervosa, amenorrhea, diagnostic criteria, DSM-III-R, psychiatric comorbidity, family history (medicine), early life experience, women, community-based epidemiology
- MeSH terms
- Adolescent, Adult, Amenorrhea, Anorexia Nervosa, Cross-Sectional Studies, Female, Humans, Middle Aged, Ontario, Psychiatric Status Rating Scales, Psychometrics, Reproducibility of Results, Comorbidity, Incidence
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