Endocrine profiles and neuropsychologic correlates of functional hypothalamic amenorrhea in adolescents.
OBJECTIVE
To determine trigger factors and neuropsychologic correlates of functional hypothalamic amenorrhea (FHA) in adolescence and to evaluate the correlations with the endocrine-metabolic profile.


METHODS
Cross-sectional comparison of adolescents with FHA and eumenorrheic controls


METHODS
Academic medical institution


METHODS
Twenty adolescent girls with FHA (aged <18 years) and 20 normal cycling girls


METHODS
All subjects underwent endocrine-gynecologic (hormone) and neuropsychiatric (tests and interview) investigations. A separate semistructured interview was also used to investigate parents.


METHODS
Gonadotropins, leptin, prolactin, androgens, estrogens, cortisol, carrier proteins (SHBG, insulin-like growth factor-binding protein 1), and metabolic parameters (insulin, insulin-like growth factor 1, thyroid hormones) were assayed in FHA and control subjects. All girls were evaluated using a test for depression, a test for disordered eating, and a psychodynamic semistructured interview.


RESULTS
Adolescents with FHA showed a particular susceptibility to common life events, restrictive disordered eating, depressive traits, and psychosomatic disorders. The endocrine-metabolic profile was strictly correlated to the severity of the psychopathology.


CONCLUSIONS
Functional hypothalamic amenorrhea in adolescence is due to a particular neuropsychologic vulnerability to stress, probably related to familial relationship styles, expressed by a proportional endocrine impairment.
Bomba
Monica
M
Department of Childhood and Adolescent Neuropsychiatry, University of Brescia, School of Medicine, Brescia, Italy. monica_bomba@libero.it <monica_bomba@libero.it>
Gambera
Alessandro
A
Bonini
Luisa
L
Peroni
Maria
M
Neri
Francesca
F
Scagliola
Pasquale
P
Nacinovich
Renata
R
D000293:Adolescent; D000568:Amenorrhea / Q000209:etiology / Q000378:metabolism / Q000523:psychology*; D001007:Anxiety / Q000378:metabolism; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003863:Depression / Q000378:metabolism; D001068:Feeding and Eating Disorders / Q000378:metabolism; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006062:Gonadotropins / Q000097:blood; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007027:Hypothalamic Diseases / Q000209:etiology / Q000378:metabolism / Q000523:psychology*; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; D020738:Leptin / Q000097:blood; D011602:Psychophysiologic Disorders / Q000378:metabolism; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013315:Stress, Psychological / Q000378:metabolism
D012739:Gonadal Steroid Hormones; D006062:Gonadotropins; D006728:Hormones; C032231:IGFBP1 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1; D020738:Leptin; D012738:Sex Hormone-Binding Globulin; D006854:Hydrocortisone