Giles D E, Berga S L
Department of Psychiatry, University of Pittsburgh, Pennsylvania 15213.
Fertil Steril. 1993 Sep;60(3):486-92.
To assess the association of cognitive function, emotional, and psychiatric history in women with functional hypothalamic amenorrhea compared with amenorrheic and eumenorrheic controls.
Each subject was medically evaluated for origin of amenorrhea or to establish eumenorrhea. Subjects completed a structured psychiatric interview and self-report questionnaires.
Patients were recruited from a large reproductive endocrinology practice within a tertiary referral center.
PATIENTS/PARTICIPANTS: Consecutive patients who were eligible for the study were invited to participate. Eumenorrheic controls were recruited to match women with functional hypothalamic amenorrhea by age, sex, weight, and season.
Cognitive measures assessed expectation of control, perfectionism, rigidity of ideas and concern about judgments of others (dysfunctional attitudes), coping ability, interpersonal and achievement functioning, and interpersonal dependence. Measures of mood and symptoms included both clinical and self-report scales. Psychiatric diagnoses were determined using Research Diagnostic Criteria and DSM III-R.
Women with functional hypothalamic amenorrhea endorsed more dysfunctional attitudes, had greater difficulty in coping with daily stresses, and tended to endorse greater interpersonal dependence than eumenorrheic women. Women with organic amenorrhea were statistically not different from either group but tended to report less dysfunctional attitudes and interpersonal dependence, although they displayed comparable difficulty in coping, compared with functional hypothalamic amenorrhea women. Women with functional hypothalamic amenorrhea more often had a history of psychiatric disorders, primarily mood disorders, than eumenorrheic women but were not different from women with organic amenorrhea.
Women with functional hypothalamic amenorrhea showed increased cognitive dysfunction and psychiatric morbidity.
评估功能性下丘脑性闭经女性的认知功能、情绪及精神病史，并与闭经和月经正常的对照组进行比较。
对每位受试者进行医学评估以确定闭经原因或建立月经正常状态。受试者完成结构化精神访谈和自我报告问卷。
患者从三级转诊中心的大型生殖内分泌诊所招募。
患者/参与者：邀请符合研究条件的连续患者参与。月经正常的对照组根据年龄、性别、体重和季节与功能性下丘脑性闭经女性进行匹配。
认知测量评估控制期望、完美主义、观念僵化以及对他人评判的担忧（功能失调态度）、应对能力、人际和成就功能以及人际依赖。情绪和症状测量包括临床和自我报告量表。使用研究诊断标准和《精神疾病诊断与统计手册》第三版修订本确定精神疾病诊断。
与月经正常的女性相比，功能性下丘脑性闭经女性表现出更多功能失调态度，应对日常压力困难更大，且倾向于表现出更强的人际依赖。器质性闭经女性在统计学上与两组均无差异，但与功能性下丘脑性闭经女性相比，她们倾向于报告较少的功能失调态度和人际依赖，尽管在应对方面表现出相当的困难。与月经正常的女性相比，功能性下丘脑性闭经女性更常患有精神疾病史，主要是情绪障碍，但与器质性闭经女性无差异。
功能性下丘脑性闭经女性表现出认知功能障碍和精神疾病发病率增加。
