Special Section Review Article/Eating Disorders in DSM-V: Review of Existing Literature (Part 1)
Should amenorrhea be a diagnostic criterion for anorexia nervosa?
Article first published online: 20 JUL 2009
Copyright © 2009 American Psychiatric Association. This Article is being co-published by the International Journal of Eating Disorders and the American Psychiatric Association.
International Journal of Eating Disorders
Volume 42, Issue 7, pages 581–589, November 2009
How to Cite
Attia, E., Roberto, C. A. (2009), Should amenorrhea be a diagnostic criterion for anorexia nervosa?. Int. J. Eat. Disord., 42: 581–589. doi: 10.1002/eat.20720
- Issue published online: 16 OCT 2009
- Article first published online: 20 JUL 2009
- Manuscript Accepted: 9 JUN 2009
- anorexia nervosa;
- diagnostic criteria;
- eating disorder not otherwise specified;
The removal of the amenorrhea criterion for anorexia nervosa (AN) is being considered for the fifth edition of The Diagnostic and Statistical Manual (DSM-V). This article presents and discusses the arguments for maintaining as well as those for removing the criterion.
The psychological and biological literatures on the utility of amenorrhea as a distinguishing diagnostic criterion for AN and as an indicator of illness severity are reviewed.
The findings suggest that the majority of differences among patients with AN who do and do not meet the amenorrhea criterion appear largely to reflect nutritional status. Overall, the two groups have few psychological differences. There are mixed findings regarding biological differences between those with AN who do and do not menstruate and the relationship between amenorrhea and bone health among patients with AN.
Based on these findings, one option is to describe amenorrhea in DSM-V as a frequent occurrence among individuals with AN that may provide important information about clinical severity, but should not be maintained as a core diagnostic feature. The possibilities of retaining the criterion or eliminating it altogether are discussed. © 2009 American Psychiatric Association. Int J Eat Disord 2009