Anastasios Tranoulis1,2, Alexandra Soldatou3, Dimitra Georgiou4, Despoina Mavrogianni5, Dimitios Loutradis6, Lina Michala6. 1. Department of Obstetrics and Gynaecology, Guy's and St Thomas' NHS Foundation, King's College, London, UK. tasostranoulis@yahoo.com. 2. First Department of Obstetrics and Gynecology, School of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece. tasostranoulis@yahoo.com. 3. Second Department of Paediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece. 4. Department of Obstetrics and Gynaecology, Chelsea and Westminster NHS Trust, Imperial College, London, UK. 5. Molecular Biology Unit, Division of Human Reproduction, First Department of Obstetrics and Gynaecology, Alexandra Hospital, Athens University Medical School, Athens, Greece. 6. Department of Obstetrics and Gynaecology, Guy's and St Thomas' NHS Foundation, King's College, London, UK.
Abstract
PURPOSE: To ascertain the role of deranged eating behaviours (DEBs) in the development of functional hypothalamic amenorrhoea (FHA) and the reciprocal role of psychopathological traits on both disorders. METHODS: A prospective case-control study was conducted spanning the period January 2016 to April 2018. Forty-one consecutive FHA females and 86 healthy controls were recruited. We assessed the DEBs and other FHA predisposing factors via self-reported questionnaires. Possible correlations amongst the variables were examined using the Spearman's correlation coefficient (rho), whilst multivariate logistic regression was carried out to identify independent predictors of DEBs. RESULTS: Mean scores on Eating Attitudes Test-26 (EAT-26) were significantly higher in females with FHA (p < 0.0001). Women with FHA were characterised by significantly higher scores at the sub-scale items of dieting (p = 0.03) and bulimia and food preoccupation (p < 0.001) compared to healthy controls. Significant difference was also observed between the mean scores of the two groups in all other questionnaires: State-Trait-Anxiety-Inventory (STAI) (p < 0.0001), Multidimensional Body-Self-Relations Questionnaire (MBSRQ) (p < 0.0001) and International Physical Activity Questionnaire (IPAQ) (p = 0.004). EAT-26 scores were positively correlated with scores on STAI (ρ = 0.26, p = 0.04), MBSRQ (ρ = 0.79, p < 0.0001) and IPAQ (ρ = 0.35, p = 0.03). High scores on IPAQ and STAI were correlated with a 12.2-fold (p = 0.008) and 4.3-fold (p = 0.04) increased risk for high scores on EAT-26 respectively. CONCLUSIONS: DEBs may occur in FHA populations at a higher frequency compared to the general population. Anxiety and overweight preoccupation may underlie and independently contribute to development and maintenance of both DEBs and FHA. This evidence may have future implications for both screening and interventions that target DEBs and other psychological factors.
PURPOSE: To ascertain the role of deranged eating behaviours (DEBs) in the development of functional hypothalamic amenorrhoea (FHA) and the reciprocal role of psychopathological traits on both disorders. METHODS: A prospective case-control study was conducted spanning the period January 2016 to April 2018. Forty-one consecutive FHA females and 86 healthy controls were recruited. We assessed the DEBs and other FHA predisposing factors via self-reported questionnaires. Possible correlations amongst the variables were examined using the Spearman's correlation coefficient (rho), whilst multivariate logistic regression was carried out to identify independent predictors of DEBs. RESULTS: Mean scores on Eating Attitudes Test-26 (EAT-26) were significantly higher in females with FHA (p < 0.0001). Women with FHA were characterised by significantly higher scores at the sub-scale items of dieting (p = 0.03) and bulimia and food preoccupation (p < 0.001) compared to healthy controls. Significant difference was also observed between the mean scores of the two groups in all other questionnaires: State-Trait-Anxiety-Inventory (STAI) (p < 0.0001), Multidimensional Body-Self-Relations Questionnaire (MBSRQ) (p < 0.0001) and International Physical Activity Questionnaire (IPAQ) (p = 0.004). EAT-26 scores were positively correlated with scores on STAI (ρ = 0.26, p = 0.04), MBSRQ (ρ = 0.79, p < 0.0001) and IPAQ (ρ = 0.35, p = 0.03). High scores on IPAQ and STAI were correlated with a 12.2-fold (p = 0.008) and 4.3-fold (p = 0.04) increased risk for high scores on EAT-26 respectively. CONCLUSIONS: DEBs may occur in FHA populations at a higher frequency compared to the general population. Anxiety and overweight preoccupation may underlie and independently contribute to development and maintenance of both DEBs and FHA. This evidence may have future implications for both screening and interventions that target DEBs and other psychological factors.