Should amenorrhoea be necessary for the diagnosis of anorexia nervosa? Evidence from a Canadian community sample

Br J Psychiatry. 1996 Apr;168(4):500-6. doi: 10.1192/bjp.168.4.500.

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.

MeSH terms

  • Adolescent
  • Adult
  • Amenorrhea / epidemiology
  • Amenorrhea / psychology*
  • Anorexia Nervosa / diagnosis*
  • Anorexia Nervosa / epidemiology
  • Anorexia Nervosa / psychology
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Middle Aged
  • Ontario / epidemiology
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychometrics
  • Reproducibility of Results