The implications of the COVID-19 pandemic on eating disorder features and comorbid psychopathology among adolescents with anorexia nervosa and matched controls: a comparative cohort design study.

Katrien Bracké, Cathelijne Steegers, Tess van der Harst, Rozemarijn Pons, Jeroen Legerstee, Bram Dierckx, Pieter de Nijs, Marieke Bax-van Berkel, Annemarie van Elburg, Marion Hekkelaan, Joke Hokke, Hetty de Jong-Zuidema, Lucas Korthals Altes, Farida Lengton-van der Spil, Judith Luijkx, Femke Schuurmans, Carien Smeets, Lia van Wijk, Claire Woltering, Meike Vernooij, Manon Hillegers, Tonya White, Gwen Dieleman
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Abstract

Purpose: To examine implications of the COVID-19 pandemic on eating disorder (ED) features and psychopathology in female adolescents with anorexia nervosa (AN).

Method: In total 79 females with first-onset AN (aged 12-22 years) were included and were followed up across a period of 1 year. We assessed AN participants recruited pre-pandemic (n = 49) to those recruited peri-pandemic (n = 30). Pre- (n = 37) and peri-pandemic (n = 38) age-, and education-matched typically developing (TD) girls (n = 75) were used as a reference cohort. ED features and psychopathology were assessed at baseline. After 1 year of follow-up the association between pandemic timing and clinical course was assessed. Analyses of covariance were used to examine differences in ED features and psychopathology.

Results: Peri-pandemic AN participants experienced less ED symptoms at baseline compared to pre-pandemic AN participants. In particular, they were less dissatisfied with their body shape, and experienced less interpersonal insecurity. In addition, the peri-pandemic AN group met fewer DSM-IV criteria for comorbid disorders, especially anxiety disorders. In contrast, peri-pandemic AN participants had a smaller BMI increase over time. In TD girls, there were no differences at baseline in ED features and psychopathology between the pre- and peri-pandemic group.

Conclusion: Overall, peri-pandemic AN participants were less severely ill, compared to pre-pandemic AN participants, which may be explained by less social pressure and peer contact, and a more protective parenting style during the pandemic. Conversely, peri-pandemic AN participants had a less favorable clinical course, which may be explained by reduced access to health care facilities during the pandemic.

Level of evidence: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

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COVID-19大流行对神经性厌食症青少年和匹配对照组饮食失调特征和合并精神病理学的影响:一项队列设计比较研究。
目的:研究COVID-19大流行对神经性厌食症(AN)女性青少年饮食失调(ED)特征和精神病理学的影响:共纳入 79 名首次发病的厌食症女性患者(12-22 岁),并对其进行为期 1 年的随访。我们对大流行前(49 人)和大流行期间(30 人)的厌食症患者进行了评估。与大流行前(n = 37)和大流行期(n = 38)年龄和教育程度相匹配的典型发育(TD)女孩(n = 75)作为参照队列。基线评估包括 ED 特征和心理病理学。随访一年后,评估大流行时间与临床病程之间的关联。采用协方差分析来检验 ED 特征和心理病理学方面的差异:结果:与大流行前的AN参与者相比,大流行前的AN参与者在基线时的ED症状较少。尤其是,他们对自己体形的不满意程度较低,人际关系中的不安全感也较少。此外,围大流行期AN组符合DSM-IV标准的合并症(尤其是焦虑症)较少。相比之下,围大流行性厌食症参与者的体重指数(BMI)随时间的增长幅度较小。在TD女孩中,流行前组和流行周组的ED特征和精神病理学基线没有差异:总体而言,与大流行前的 AN 患者相比,大流行期间的 AN 患者病情较轻,这可能是因为大流行期间的社会压力和同伴接触较少,以及父母的保护性教育方式较强。相反,围大流行期的AN参与者的临床病程较轻,这可能是由于大流行期间获得医疗保健设施的机会较少:III级:从设计良好的队列或病例对照分析研究中获得的证据。
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来源期刊
CiteScore
6.50
自引率
10.30%
发文量
170
审稿时长
>12 weeks
期刊介绍: Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity is a scientific journal whose main purpose is to create an international forum devoted to the several sectors of eating disorders and obesity and the significant relations between them. The journal publishes basic research, clinical and theoretical articles on eating disorders and weight-related problems: anorexia nervosa, bulimia nervosa, subthreshold eating disorders, obesity, atypical patterns of eating behaviour and body weight regulation in clinical and non-clinical populations.
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