LONGITUDINAL FOLLOW-UP OF AMENORRHEA IN EATING DISORDERS

The authors recruited 229 treatment-seeking anorexic and bulimic women for a prospective, longitudinal study. Telephone interviews were arra nged every 3 months for at least 1 year for 225 patients. At intake, 1 32 subjects were menstruating, 34 subjects were taking oral contracept ives, 5 subjects had an organic cause for amenorrhea (e.g., hysterecto my), and 58 subjects were amenorrheic. Each patient met Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-I II-R) criteria for anorexia nervosa (AN, N = 41), bulimia nervosa (BN, N = 98), or AN/BN (N = 90), All subjects were interviewed with the Sc hedule for Affective Disorders and Schizophrenia-Lifetime Version, whi ch was modified to include a section for DSM-III-R eating disorders, t he Longitudinal Interval Follow-Up Evaluation, and the Structured Inte rview for DSM-III Personality Disorders. It was found that body weight was associated with menstrual status: those with amenorrhea had a mea n percent ideal body weight (IBW, Metropolitan Life criteria) of 74 +/ - 1% compared with 102 +/- 19% for menstruating patients (p < .01). Af fective illness was more prevalent among patients with amenorrhea than among menstruating patients (75% vs. 56%, p < .05). Menses were regai ned within 1 year by 33% of amenorrheic patients. These patients gaine d an average of 7.3% of their IBW. Longer duration of eating disorder (p < .03) and the presence of an anxiety disorder (p < .05) were assoc iated with persistent amenorrhea. Menses were lost within 1 year by 8% of menstruating patients. These patients lost an average of 5.0% of t heir IBW. In conclusion, among patients with eating disorders, low wei ght and affective illness were associated with amenorrhea; longer dura tion of eating disorder and presence of anxiety disorders were associa ted with persistent amenorrhea.