Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-05T03:00:25.975Z Has data issue: false hasContentIssue false

Should Amenorrhoea be Necessary for the Diagnosis of Anorexia Nervosa?

Evidence from a Canadian Community Sample

Published online by Cambridge University Press:  02 January 2018

Paul E. Garfinkel*
Affiliation:
Health Systems Research Unit, Clarke Institute of Psychiatry, and Department of Psychiatry and Faculty of Nursing, University of Toronto
E. Lin
Affiliation:
Health Systems Research Unit, Clarke Institute of Psychiatry, and Department of Psychiatry and Faculty of Nursing, University of Toronto
P. Goering
Affiliation:
Health Systems Research Unit, Clarke Institute of Psychiatry, and Department of Psychiatry and Faculty of Nursing, University of Toronto
C. Spegg
Affiliation:
Clarke Institute of Psychiatry and University of Toronto
D. Goldbloom
Affiliation:
Clarke Institute of Psychiatry and University of Toronto
S. Kennedy
Affiliation:
Clarke Institute of Psychiatry and University of Toronto
A. S. Kaplan
Affiliation:
Head Program for Eating Disorders, The Toronto Hospital and Department of Psychiatry, University of Toronto
D. Blake Woodside
Affiliation:
Eating Disorders Inpatient Program, The Toronto Hospital and University of Toronto
*
Dr Garfinkel, Clarke Institute of Psychiatry, 250 College Street, Toronto, Ontario, Canada M5T 1R8

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.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1996 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Bruch, H. (1973) Eating Disorders. New York: Basic Books.Google Scholar
Crisp, A., Palmer, R. & Kalucy, R. (1976) How common is anorexia nervosa? A prevalence study. British Journal of Psychiatry, 122, 545559.Google Scholar
Dancyger, I. F. & Garfinkel, P. E. (1995) The relationship of partial syndrome eating disorders to anorexia nervosa and bulimia nervosa. Psychological Medicine, 25, 10191025.CrossRefGoogle ScholarPubMed
Garfinkel, P. E. (1995) Classification and diagnosis of eating disorders. In Eating Disorders and Obesity: A Comprehensive Handbook (eds Brownell, K. D. & Fairburn, C.), pp. 125134. New York: Guilford Press.Google Scholar
Garfinkel, P. E. & Garner, D. M. (1982) Anorexia Nervosa: A Multidimensional Perspective. New York: Brunner/Mazel.Google Scholar
Garfinkel, P. E., Lin, B., Goering, P., et al (1995) Bulimia nervosa in a Canadian community sample: prevalence and co-morbidity. American Journal of Psychiatry, 152, 10521058.Google Scholar
Garner, D. M., Olmsted, M., Polivy, J., et al (1984) Comparison between weight-preoccupied women and anorexia nervosa. Psychosomatic Medicine, 46, 255266.Google Scholar
Golden, N. H. & Shenker, I. R. (1994) Amenorrhea in anorexia nervosa: neuroendocrine control of hypothalamic dysfunction. International Journal of Eating Disorders, 16, 5360.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Herzog, D. B., Hopkins, J. D. & Burns, C. D. (1993) A follow-up study of 33 subdiagnostic eating disordered women. International Journal of Eating Disorders, 14, 261267.Google Scholar
King, M. B. (1989) Eating disorders in a general practice population. Prevalence, characteristics and follow-up at 12 to 18 months. Psychological Medicine, 14 (suppl.), 134.Google Scholar
Lucas, A. R., Beard, C. M., O'Fallon, W. M., et al (1991) 50-year trends in the incidence of anorexia nervosa in Rochester, Minn: a population-based study. American Journal of Psychiatry, 148, 917922.Google Scholar
Offord, D. R., Boyle, M., Campbell, D., et al (1994) Mental health in Ontario: Selected findings from the Ontario Health Supplement to the 1990 Ontario Health Survey. Report to the Ontario Ministry of Health.Google Scholar
Piran, N., Lerner, P., Garfinkel, P. E., et al (1988) Personality disorders in restricting and bulimic forms of anorexia nervosa. International Journal of Eating Disorders, 7, 589599.Google Scholar
Rastam, M., Gillberg, C. & Garton, M. (1989) Anorexia nervosa in a Swedish urban region: a population-based study. British Journal of Psychiatry, 155, 642646.Google Scholar
Russell, G. F. M. (1970) Anorexia nervosa: its identity as an illness and its treatment. In Modern Trends in Psychological Medicine (ed. Price, J. H.), pp. 131164. London: Butterworth.Google Scholar
Theander, S. (1970) Anorexia nervosa: a psychiatric investigation of 94 female patients. Acta Psychiatrica Scandinavica, Suppl. 214.Google Scholar
Walters, E. & Kendler, K. (1995) Anorexia nervosa and anorexic-like symptoms in a population-based female twin study. American Journal of Psychiatry, 152, 6471.Google Scholar
Whitehouse, A.M., Cooper, P. J., Vize, C. V., et al (1992) Prevalence of eating disorders in three Cambridge general practices: hidden and conspicuous morbidity. British Journal of General Practice, 42, 5760.Google Scholar
Wittchen, H.-U. (1994) Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): A critical review. Journal of Psychiatric Research, 28, 5784.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.