Reproductive and Psychological Outcomes of Eating Disorders
Year: 2014
Type: dissertation
Study design: Observational Study
Abstract: The aim of this thesis was to study the impact of eating disorders on young women's reproductive and psychological health in both clinical and population-based settings. Two samples of women were utilized to meet these goals. First, women treated at the eating disorder clinic of Helsinki University Central Hospital during 1995-2010 (n=2257) were compared with matched controls drawn from the Central Population Register (n=9028). Register-based measures of general reproductive outcomes, course of pregnancy and childbirth, and perinatal health outcomes were compared across these two groups in Studies I and II. Second, twins born in Finland during 1975-1979 (FinnTwin16, n=2825 women) were assessed at the age of 22-28 years by means of a mailed questionnaire that included several measures of psychological health as well as a screen for eating disorders, followed by diagnostic interviews. Studies III-V compared the twins with a history of lifetime eating disorders with their unaffected twin sisters and healthy women to evaluate recovery rates and psychological outcomes. The probability of recovery from anorexia nervosa and bulimia nervosa in the twin sample five years after the onset of the illness was 67% and 57%, respectively. Many of the women treated for an eating disorder had experienced reproductive health problems at follow-up, but most of them had no complications in pregnancy or childbirth. In the clinical sample, an increased likelihood of remaining childless was found among women with anorexia nervosa, whereas women with bulimia nervosa were more likely to experience induced abortion, and miscarriage was common among women with binge eating disorder (BED) in comparison with the controls. Maternal anorexia nervosa and BED were related to abnormal patterns of fetal growth during pregnancy. Significantly, severe perinatal health complications were observed in women treated for anorexia nervosa or bulimia nervosa. The psychological outcomes of anorexia nervosa and bulimia nervosa were more favorable in the twin cohort than previously reported. Recovery was slow and gradual, but most women with anorexia nervosa reached the level of their unaffected twin sisters in terms of psychological health over time. The course of bulimia nervosa was marked by a more gradual easing of symptoms. Body dissatisfaction and psychosomatic symptoms seemed to be the most persistent residua of both illnesses. Overall, the outcome was poor for some, but favorable for most women with a history of eating disorders. Several reproductive health problems were observed among women who had received treatment, suggesting the need for enhanced monitoring of pregnancies among these women. However, in the twin cohort, most women with a history of eating disorders proceeded towards recovery, did not experience reproductive impairment, and, on measures of psychological health, resembled their unaffected twin sisters more closely over time.
Source: Työväentutkimus Vuosikirja
Author: Milla S. Linna
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W1525145581