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Minerva Psichiatrica 2010 June;51(2):127-33

language: Italian

Anorexia nervosa: a diagnostic criterion amenorrhea review

Abbate Daga G., Notaro G., Quaranta M., Urani C., Barbieri A., Fassino S.

Dipartimento di Neuroscienze dell’Università di Torino, SCDU Psichiatria CPR DCA AOU San Giovanni Battista di Torino, Torino, Italia


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Today is discussed the possibility of removal of amenorrhoa criterion for the diagnosis of anorexia nervosa (AN) in the future Diagnostic and Statistical Manual of mental Disorders fifth edition (DSM V). This is a review of the articles dedicated to this issue and we made a critical discussion of results. The research made on MEDLINE and the articles that analyzed amenorrhoa as a diagnostic criterion and illness index were taken. Fifteen articles respond to inclusion criteria. The removal suggestion is made in 5 articles, other 5 articles suggested further elaborations. 3 article underlined amenorrhea is dependent more on nutritional state than psychopathology. Every article doubted the effective usefulness of amenorrhea as a diagnostic criterion. Patients who received EDNOS diagnosis instead AN only for amenorrhea absence have psychopathology comparable to patients with AN full criteria. Amenorrhea is linked to nutritional state, so it is more a biomarker of the state of health than a psychopathologic index. Amenorrhea can persist a long time after the eating disorder recovery. It is certain the effectiveness of the symptom amenorrhea to clinicians, but the utility as a diagnostic criterion is restricted and its inclusion in the DSM V diagnostic criteria uncertain.

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