TY - JOUR A1 - Dempfle, Astrid A1 - Herpertz-Dahlmann, Beate A1 - Timmesfeld, Nina A1 - Schwarte, Reinhild A1 - Egberts, Karin M. A1 - Pfeiffer, Ernst A1 - Fleischhaker, Christian A1 - Wewetzer, Christoph A1 - Bühren, Katharina T1 - Predictors of the resumption of menses in adolescent anorexia nervosa JF - BMC Psychiatry N2 - Background: The resumption of menses is an important indicator of recovery in anorexia nervosa (AN). Patients with early-onset AN are at particularly great risk of suffering from the long-term physical and psychological consequences of persistent gonadal dysfunction. However, the clinical variables that predict the recovery of menstrual function during weight gain in AN remain poorly understood. The aim of this study was to investigate the impact of several clinical parameters on the resumption of menses in first-onset adolescent AN in a large, well-characterized, homogenous sample that was followed-up for 12 months. Methods: A total of 172 female adolescent patients with first-onset AN according to DSM-IV criteria were recruited for inclusion in a randomized, multi-center, German clinical trial. Menstrual status and clinical variables (i.e., premorbid body mass index (BMI), age at onset, duration of illness, duration of hospital treatment, achievement of target weight at discharge, and BMI) were assessed at the time of admission to or discharge from hospital treatment and at a 12-month follow-up. Based on German reference data, we calculated the percentage of expected body weight (%EBW), BMI percentile, and BMI standard deviation score (BMI-SDS) for all time points to investigate the relationship between different weight measurements and resumption of menses. Results: Forty-seven percent of the patients spontaneously began menstruating during the follow-up period. %EBW at the 12-month follow-up was strongly correlated with the resumption of menses. The absence of menarche before admission, a higher premorbid BMI, discharge below target weight, and a longer duration of hospital treatment were the most relevant prognostic factors for continued amenorrhea. Conclusions: The recovery of menstrual function in adolescent patients with AN should be a major treatment goal to prevent severe long-term physical and psychological sequelae. Patients with premenarchal onset of AN are at particular risk for protracted amenorrhea despite weight rehabilitation. Reaching and maintaining a target weight between the 15th and 20th BMI percentile is favorable for the resumption of menses within 12 months. Whether patients with a higher premorbid BMI may benefit from a higher target weight needs to be investigated in further studies. KW - girls KW - amenorrhea KW - brain KW - increases KW - return KW - menarche KW - target weight KW - adolescence anorexia nervosa KW - resumption of menses KW - recovery KW - ovarian function KW - weight gain KW - eating disorders KW - bone-mineral density KW - menstrual recovery KW - outcome KW - body mass index Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-122106 VL - 13 IS - 308 ER - TY - JOUR A1 - Jaite, Charlotte A1 - Bühren, Katharina A1 - Dahmen, Brigitte A1 - Dempfle, Astrid A1 - Becker, Katja A1 - Correll, Christoph U. A1 - Egberts, Karin M. A1 - Ehrlich, Stefan A1 - Fleischhaker, Christian A1 - von Gontard, Alexander A1 - Hahn, Freia A1 - Kolar, David A1 - Kaess, Michael A1 - Legenbauer, Tanja A1 - Renner, Tobias J. A1 - Schulze, Ulrike A1 - Sinzig, Judith A1 - Thomae, Ellen A1 - Weber, Linda A1 - Wessing, Ida A1 - Antony, Gisela A1 - Hebebrand, Johannes A1 - Föcker, Manuel A1 - Herpertz-Dahlmann, Beate T1 - Clinical Characteristics of Inpatients with Childhood vs. Adolescent Anorexia Nervosa JF - Nutrients N2 - We aimed to compare the clinical data at first presentation to inpatient treatment of children (<14 years) vs. adolescents (≥14 years) with anorexia nervosa (AN), focusing on duration of illness before hospital admission and body mass index (BMI) at admission and discharge, proven predictors of the outcomes of adolescent AN. Clinical data at first admission and at discharge in 289 inpatients with AN (children: n = 72; adolescents: n = 217) from a German multicenter, web-based registry for consecutively enrolled patients with childhood and adolescent AN were analyzed. Inclusion criteria were a maximum age of 18 years, first inpatient treatment due to AN, and a BMI <10th BMI percentile at admission. Compared to adolescents, children with AN had a shorter duration of illness before admission (median: 6.0 months vs. 8.0 months, p = 0.004) and higher BMI percentiles at admission (median: 0.7 vs. 0.2, p = 0.004) as well as at discharge (median: 19.3 vs. 15.1, p = 0.011). Thus, in our study, children with AN exhibited clinical characteristics that have been associated with better outcomes, including higher admission and discharge BMI percentile. Future studies should examine whether these factors are actually associated with positive long-term outcomes in children. KW - anorexia nervosa KW - children KW - adolescents KW - clinical characteristics KW - BMI KW - outcome Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-193160 SN - 2072-6643 VL - 11 IS - 11 ER - TY - JOUR A1 - Föcker, Manuel A1 - Timmesfeld, Nina A1 - Bühlmeier, Judith A1 - Zwanziger, Denise A1 - Führer, Dagmar A1 - Grasemann, Corinna A1 - Ehrlich, Stefan A1 - Egberts, Karin A1 - Fleischhaker, Christian A1 - Wewetzer, Christoph A1 - Wessing, Ida A1 - Seitz, Jochen A1 - Herpertz-Dahlmann, Beate A1 - Hebebrand, Johannes A1 - Libuda, Lars T1 - Vitamin D level trajectories of adolescent patients with anorexia nervosa at inpatient admission, during treatment, and at one year follow up: association with depressive symptoms JF - Nutrients N2 - (1) Background: Evidence has accumulated that patients with anorexia nervosa (AN) are at higher risk for vitamin D deficiency than healthy controls. In epidemiologic studies, low 25(OH) vitamin D (25(OH)D) levels were associated with depression. This study analyzed the relationship between 25(OH)D serum levels in adolescent patients and AN and depressive symptoms over the course of treatment. (2) Methods: 25(OH)D levels and depressive symptoms were analyzed in 93 adolescent (in-)patients with AN from the Anorexia Nervosa Day patient versus Inpatient (ANDI) multicenter trial at clinic admission, discharge, and 1 year follow up. Mixed regression models were used to analyze the relationship between 25(OH)D levels and depressive symptoms assessed by the Beck Depression Inventory (BDI-II). (3) Results: Although mean 25(OH)D levels constantly remained in recommended ranges (≥50 nmol/L) during AN treatment, levels decreased from (in)patient admission to 1 year follow up. Levels of 25(OH)D were neither cross-sectionally, prospectively, nor longitudinally associated with the BDI-II score. (4) Conclusions: This study did not confirm that 25(OH)D levels are associated with depressive symptoms in patients with AN. However, increasing risks of vitamin D deficiency over the course of AN treatment indicate that clinicians should monitor 25(OH)D levels. KW - vitamin D KW - supplements KW - anorexia nervosa KW - depressive symptoms KW - adolescents Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-242662 SN - 2072-6643 VL - 13 IS - 7 ER -