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.
Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Ave., MC3077, Chicago, IL, 60637, USA.
J Eat Disord. 2013 Apr 8;1:12. doi: 10.1186/2050-2974-1-12. eCollection 2013.
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.
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.
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.
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.
对于神经性厌食症（AN）患者来说，月经恢复（ROM）被认为是体重恢复的一个重要临床指标。本研究旨在探讨 AN 青少年患者的 ROM 与预期体重（EBW）和心理社会指标的关系。
我们对 2001 年 9 月至 2011 年 9 月期间在芝加哥大学饮食失调项目进行了回顾性病历审查（N=225 名患有 AN 的女性）。确定了 84 名患有 AN 的青少年（平均年龄 15.1，标准差 2.2），表现为继发性闭经。所有参与者均接受了一个疗程的门诊家庭为基础的治疗（FBT），即 12 个月内约 20 次治疗。在整个治疗过程中，每次治疗时都会记录体重和月经状况。主要的观察指标是体重（性别、年龄和身高的预期百分比）和 ROM。
基线时平均 EBW 百分比为 82.0（标准差 6.5）。67.9%（57/84）的参与者报告了 ROM，平均为 94.9（标准差 9.3）%的 EBW，并且在完成平均 13.5（标准差 10.7）次 FBT 治疗后（约 70%的标准 FBT）。与治疗结束时没有 ROM 的参与者相比，有 ROM 的参与者的饮食障碍检查全球评分基线明显更高（p=0.004），以及形体担忧（p<0.008）和节制（p<0.002）分量表评分也更高。没有发现其他差异。
结果表明，ROM 发生在接近 EBW 参考百分比的体重，并且较高的治疗前饮食障碍心理病理学与 ROM 相关。未来的研究对于更好地理解这些差异及其对 AN 青少年治疗的影响非常重要。
