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Anorexia nervosa (AN) is a mental health disorder whose features are deliberate weight loss, disordered body image, and intrusive overvalued fears of gaining weight. Long term consequences of AN include endocrine dysfunctions resulting in low levels of gonadotropins and estrogens, secondary amenorrhea, bone loss and/or osteoporosis. Bone reabsorption is related with the exposure to low levels of estrogens leading to an increased risk of bone fractures as it happens in late postmenopausal period and young women with AN may develop a risk for pathological fractures comparable to that of menopausal women.
Objective:
In our case report series we examined the influence of AN related amenorrhea on bone mineral density (BMD).
Methodology:
We evaluated BMD with computerised bone mineralometry (CBM) in 10 women with diagnosis of AN, hospitalized in the Psychiatric Clinic of University of Pisa.
Results:
All the patients showed a lumbar and femoral bone loss or osteoporosis with an increased fracture risk in comparison with peers and comparable to that of menopausal women.
Conclusions:
Our data support the hypothesis that lower estrogenic levels associated with AN have an impact on BMD. Although osteoporotic complications and fracture risk are underdiagnosed, underestimated and potential cause of permanent disability is a predictable and treatable condition in AN patients. Therefore we recommend a more accurate evaluation of BMD with CBM in all patients with prolonged amenorrhoea.
In the perinatal period the woman is vulnerable to depression. Major and minor depression presents prevalence rates ranging respectively from 8,5 and 11% during pregnancy and between 6.5% and 12.9% in the first year post-partum. However, only a small percentage of cases are identified and treated, with negative consequences on both the mother and the baby.
Objective
To compare two samples of women at the first month postpartum, the first followed since first month of pregnancy and the second evaluated the first time in the first month postpartum, about the symptoms of depression and anxiety.
Methodology
We compared two groups of women in the first month postpartum: 271 women followed since 1 st month of pregnancy and 130 women evaluated for the first time in the first month postpartum. We administered: the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI), the Postpartum Depression Predictors Inventory-Revised (PDPI-R) and the Structured Clinical Interview for the Diagnosis of Axis I psychiatric disorders (SCID-I).
Results
In the first month postpartum, women followed since pregnancy have a significantly lower depressive symptoms and anxiety, as demonstrated by lower EPDS scores (t = −6,140, p < .001) and STAI scores (t = −4,800, p < .001).
Conclusions
Early screening can reduce rates of perinatal psychopathology and allow to identify women most at risk, allowing earlier diagnosis and better treatment management.
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