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  - 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  -