Eating disorders and Axis I psychiatric comorbidity in amenorrheic women

Objective: the present study aimed to investigate the relationship between secondary amenorrhea due to different etiologic mechanisms, eating disorders, and psychiatric morbidity in a nonpsychiatric population observed in a gynecological department Method: Amenorrheic women (n = 95) with hypogonadotropic, hyperandrogenic, and hyperprolactinemic features were interviewed individually using the SCID-R (Structured Clinical Interview for DSM-III-R) to diagnose Axis I disorders including mood disorders, anxiety disorders, somatoform disorders, adjustment disorders, and eating disorders. Binge eating disorder was diagnosed according to DSM-IV criteria. Results: The incidence of eating disorders was significantly higher in hypogonadic women than in hyperandrogenic and hyperprolactinemic subjects (chi(2) = 23.03, p <.003). However, we also found a high percentage of hyperandrogenic women suffering from an eating disorder (40.9%) with a prevalence of binge eating disorder (27.2%) while the only eating disorder described in the hyperprolactinemic group was the not otherwise specified. In addition, a marked psychiatric comorbidity was found in amenorrheic women suffering from an eating disorder but a similar trend of pathologies was also found in amenorrheic women, without any positive SCID diagnosis for an abnormal eating disorder. Discussion: Our study demonstrated that a high incidence of eating disorders, mainly anorexia and binge eating, characterizes hypogonadic and hyperandrogenic women, respectively. In addition, secondary amenorrhea displays a wide spectrum of Axis I diagnoses, without a significant comorbidity with eating disorders. Whether or not the endocrine findings related to the amenorrheic condition constitute a common background for the occurrence of psychopathology or, alternatively, the presence of psychiatric disturbances may contribute to the development of menstrual dysfunction remain to be clarified. (C) 1998 by John Wiley & Sons, Inc.