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Vavassori M, Donzelli G. Impact of COVID-19 restrictive measures during lockdown period on eating disorders: An umbrella review. Nutrition 2024; 124:112463. [PMID: 38749229 DOI: 10.1016/j.nut.2024.112463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 06/17/2024]
Abstract
The COVID-19 pandemic has sparked or amplified many mental health problems. The aim of this study was to compile evidence from existing systematic reviews to provide an overall assessment of the impact of social restrictions during the COVID-19 pandemic on people affected by eating disorders (EDs). PubMed and Scopus were searched up to August 16, 2023. Systematic reviews and meta-analyses were selected using the PRISMA 2020 statement. The quality assessment of the included studies was conducted using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Eleven studies were included in this umbrella review. Six main categories emerged from the studies described in the review: dietary changes and psychopathological effects showed an overall worsening of symptomatology; in studies concerning the impact of isolation and restrictive measures, it was found that social distancing was associated with feelings of loneliness, anxiety, and depression; limited access to direct care was found and therapeutic changes were made; the influence of mass media negatively impacted people with ED; several studies reported positive findings regarding symptomatology; finally, studies regarding 'impact on vulnerable populations showed that vulnerable people are more at risk of reporting body image distortion and eating disorders. The COVID-19 pandemic has negatively impacted most of the population with ED leading to a worsening of specific symptomatology. In addition, this worsening of the condition may be caused by limited access to care and treatment, changes in routine, or to the negative influence of the media.
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Affiliation(s)
| | - Gabriele Donzelli
- Department of Pharmacy, University of Pisa, Pisa, Italy; Institute of Clinical Physiology of the National Research Council (CNR-IFC), Pisa, Italy
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Meneguzzo P, Ceccato E, Sala A, Santonastaso P. When time worsens framing: a longitudinal analysis of the psychological effects of the COVID-19 pandemic in women with an eating disorder and their healthy sisters. Arch Womens Ment Health 2024; 27:191-199. [PMID: 37964120 PMCID: PMC10933162 DOI: 10.1007/s00737-023-01398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/08/2023] [Indexed: 11/16/2023]
Abstract
The COVID-19 pandemic has profoundly affected individuals with eating disorders (ED), leading to an exacerbation of symptoms worldwide in 2020. However, there is a lack of longitudinal analyses of the psychological burdens experienced by this population. This study aims to longitudinally assess the psychological effects of the COVID-19 pandemic in people with ED and their healthy sisters (HS) 1 and 2 years after the onset of the crisis. A sample of 148 individuals, consisting of 73 with ED and 45 HS, was evaluated in spring 2021 and spring 2022 regarding their current psychological and behavioral states. Participants were also asked to reflect on their feelings and behaviors during the 2020 lockdown. General psychopathology, eating disorders, and trauma-related symptoms were evaluated using validated questionnaires. Both groups showed an overall improvement in psychopathological symptoms with time. Individuals with ED exhibited greater improvement compared to their HS, which may be attributed to their initially higher burden. Individuals with ED reported a negative reframe, characterized by internalizing negative emotions and behaviors related to the 2020 lockdown. This longitudinal evaluation revealed two distinct and contrasting effects. Both ED patients and their HS demonstrated psychological improvement over time. However, people with ED experienced a negative reframe that affected their memory of specific life events, subsequently affecting their psychological well-being. These findings shed light on the clinical severity observed in people with ED during these pandemic years.
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Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
- Padova Neuroscience Center, University of Padova, Padova, Italy.
| | - Enrico Ceccato
- Vicenza Eating Disorders Center, Mental Health Department, Azienda ULSS8 "Berica", Vicenza, Italy
| | - Alessandra Sala
- Vicenza Eating Disorders Center, Mental Health Department, Azienda ULSS8 "Berica", Vicenza, Italy
| | - Paolo Santonastaso
- Department of Neuroscience, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
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Cole B. Understanding Eating Disorders and the Nurse's Role in Diagnosis, Treatment, and Support. J Christ Nurs 2024; 41:80-87. [PMID: 38436337 DOI: 10.1097/cnj.0000000000001147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
ABSTRACT Eating disorders (EDs) are a severe type of mental illness that nurses in many settings may encounter. The three primary eating disorders-anorexia nervosa, bulimia nervosa, and binge eating disorder-are described here. Signs, symptoms, and treatment of eating disorders are outlined, along with the importance of nurses in early identification of EDs and developing therapeutic relationships with patients. A case study and elements of spiritual care are presented.
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Affiliation(s)
- Britt Cole
- Britt Cole, MSN, RN, CPN, is an associate professor of nursing, teaching pediatrics in the BSN program at Miami University in Ohio. She has nearly 30 years of experience in pediatric nursing and is passionate about trauma-informed care of children exposed to adverse childhood events
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Maunder K, Markey O, Batchelor R, McNicholas F. A systematic review of COVID-19 and the presentation of avoidant/restrictive food intake disorder and avoidant/restrictive food intake disorder-like symptoms. BJPsych Open 2024; 10:e56. [PMID: 38433590 PMCID: PMC10951850 DOI: 10.1192/bjo.2023.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 11/20/2023] [Accepted: 12/28/2023] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The adverse effects of COVID-19 and the associated restrictions on eating disorder populations have been discussed in recent literature. However, little is known about the presentation of cases with avoidant/restrictive food intake disorder (ARFID) during this period. AIMS To explore the extent of the literature on the presentation of ARFID, and ARFID-like cases, during the COVID-19 pandemic. METHOD Cochrane Library, CINAHL (EBSCO), PsycINFO (EBSCO), EMBASE (Ovid) and Medline (Ovid) were searched for publications between March 2020 and May 2023. Google Scholar and reference lists were hand searched. At least two reviewers independently screened each paper. Narrative synthesis was used. RESULTS Seven papers were included: four case reports and three cohort studies (total ARFID sample of 46). Included papers were assessed as having high (n = 3) or moderate (n = 4) quality. Findings did not suggest an increase in ARFID cases during the COVID-19 pandemic, although it is unclear if this is because of a lack of impact or underrecognition of ARFID. A need for a multidisciplinary approach to differentiate between ARFID and organic causes of ARFID-like presentations (e.g. gastrointestinal effects of COVID-19) was highlighted. CONCLUSIONS Publications specifically pertaining to ARFID presentations during the COVID-19 pandemic have been few. Papers found have been of small sample sizes and lack subanalyses for ARFID within broader eating disorder samples. Continued surveillance is needed to evaluate any COVID-19-specific effects on the development, identification, treatment and outcomes of ARFID.
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Affiliation(s)
- Kristen Maunder
- Department of Child and Adolescent Psychiatry, University College Dublin, Ireland; Department of Liaison Child and Adolescent Psychiatry, Tallaght University Hospital, Ireland; and Department of Child and Adolescent Psychiatry, Linn Dara Child and Adolescent Mental Health Services, Dublin, Ireland
| | - Oscar Markey
- Department of Psychology, Universiteit Leiden, The Netherlands; Department of Psychology, Trinity College Dublin, Ireland; and Department of Child and Adolescent Psychiatry, Lucena St John of God's Child and Adolescent Mental Health Services, Dublin, Ireland
| | - Rachel Batchelor
- Department of Psychology, Oxford Institute of Clinical Psychology Training and Research, UK; and Department of Psychology, Oxford Health NHS Foundation Trust, UK
| | - Fiona McNicholas
- Department of Child and Adolescent Psychiatry, University College Dublin, Ireland; Department of Child and Adolescent Psychiatry, Lucena St John of God's Child and Adolescent Mental Health Services, Dublin, Ireland; and Department of Liaison Child and Adolescent Psychiatry, Children's Health Ireland at Crumlin, Ireland
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Rodrigue C, Rodgers RF, Carbonneau N, Bégin C, Dion J. COVID-19-Related distress, body image, and eating behaviors: a cross-sectional explanatory model. BMC Psychol 2024; 12:117. [PMID: 38431696 PMCID: PMC10908208 DOI: 10.1186/s40359-024-01613-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has been associated with increased body dissatisfaction and disordered eating behaviors in adolescents. To better understand these associations, this study tested an explanatory model in which appearance-focused social media use, internalization of social media pressure, and mindfulness abilities mediated the relationship between COVID-related distress and body dissatisfaction, which in turn was associated with dietary restraint and binge eating episodes. METHODS Adolescents (N = 493, Mage= 16.7; 47.5% girls) recruited within high schools completed online measures. We conducted model testing through path analysis in MPlus, using modification indices to derive a well-fitting model. RESULTS The initially hypothesized model was a poor fit for the data. The final well-adjusted model confirmed several significant paths and supported the parallel mediational roles of social media (specifically, the use of appearance-focused social media and internalization of social media pressure) along with mindfulness, on the relationship between COVID-19-related distress and body satisfaction. Model adjustments involved adding three paths, resulting in two additional significant indirect effects, and suppressing one path. CONCLUSIONS Findings suggest that mindfulness, media use and the internalization of social media pressure are potential key processes explaining body dissatisfaction and eating disorders among adolescents who experienced higher levels of COVID-related distress.
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Affiliation(s)
- Christopher Rodrigue
- Department of Psychology, University of Quebec at Trois-Rivières, 3351 des Forges Blvd, Trois-Rivières, QC, G8Z 4M3, Canada.
- Faculty of Agriculture and Food Sciences, Laval University, 2440 Hochelaga Blvd, Québec, QC, G1V 0A6, Canada.
- Intersectional Center for Sustainable Health, University of Quebec at Chicoutimi, 555 de l'Université Blvd, Chicoutimi, QC, G7H 2B1, Canada.
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, 360 Huntington Avenue, MA02115, Boston, MA, USA
| | - Noémie Carbonneau
- Department of Psychology, University of Quebec at Trois-Rivières, 3351 des Forges Blvd, Trois-Rivières, QC, G8Z 4M3, Canada
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Department of Psychology, University of Montreal, 90 Vincent d'Indy, Montreal, QC, H2V 2S9, Canada
| | - Catherine Bégin
- Faculty of Agriculture and Food Sciences, Laval University, 2440 Hochelaga Blvd, Québec, QC, G1V 0A6, Canada
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Department of Psychology, University of Montreal, 90 Vincent d'Indy, Montreal, QC, H2V 2S9, Canada
| | - Jacinthe Dion
- Department of Psychology, University of Quebec at Trois-Rivières, 3351 des Forges Blvd, Trois-Rivières, QC, G8Z 4M3, Canada
- Intersectional Center for Sustainable Health, University of Quebec at Chicoutimi, 555 de l'Université Blvd, Chicoutimi, QC, G7H 2B1, Canada
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Department of Psychology, University of Montreal, 90 Vincent d'Indy, Montreal, QC, H2V 2S9, Canada
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Usami M, Satake N, Katsuyama H, Okudera K, Uchiyama Y, Imamura M, Hayakawa T, Yanai H, Aoyanagi N. Is children's mental health an important function of newly national organization for health crisis management in Japan? PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2024; 3:e175. [PMID: 38868482 PMCID: PMC11114343 DOI: 10.1002/pcn5.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 06/14/2024]
Abstract
This review discussed analyzing information dissemination and activities related to mental health conducted by the Centers of Disease Control and Prevention (CDC), considering their application in Japan, and disseminating them to the public is necessary for the Japanese New Center for Health Control. The Japanese government also explores the Japanese New Center For Health Control in addressing children's mental health issues potentially under the Japan health crisis. The findings underscore the urgency of prioritizing children's mental health and implementing effective strategies to mitigate the long-term effects of the COVID-19 pandemic.
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Affiliation(s)
- Masahide Usami
- Department of Child and Adolescent Psychiatry, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
- Clinical Center for Children's Mental Health, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Naoko Satake
- Department of Psychiatry Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Hisayuki Katsuyama
- Department of Diabetes, Endocrinology and Metabolism, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Kaori Okudera
- Department of Nursing, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Yumiko Uchiyama
- Department of Nursing, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Masatoshi Imamura
- Department of Gastroenterology and Hepatology, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaChibaJapan
| | - Tatsuro Hayakawa
- Department of Psychiatry Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Nobuyoshi Aoyanagi
- Department of Surgery, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
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Cook-Cottone C, Harriger JA, Tylka TL, Wood-Barcalow NL. Virtually possible: strategies for using telehealth in eating disorder treatment learned from the COVID-19 pandemic. Eat Disord 2024; 32:99-119. [PMID: 37772856 DOI: 10.1080/10640266.2023.2261762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
The COVID-19 pandemic resulted in an abrupt shift from in-person to virtual treatment, and clinicians continue to offer telehealth due to its advantages. Telehealth may be a viable, effective, and safe treatment modality for many clients with eating disorders. We consider contemporary issues regarding the use of telehealth in eating disorder treatment and identify strategies to enhance its delivery. First, we emphasize key factors when choosing therapy delivery (telehealth, in-person, or hybrid). Second, we address telehealth-specific planning, preparation, safety, and privacy considerations. Third, we discuss how eating disorder assessment and evidence-based interventions can be adapted for telehealth delivery. Fourth, we raise telehealth-specific challenges related to group-based delivery and the therapeutic alliance offering alternative avenues for connection and engagement. We conclude with a discussion of how additional research is needed to refine the presented strategies, develop new strategies, and assess their efficacy and effectiveness.
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Affiliation(s)
- Catherine Cook-Cottone
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York
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Penwell TE, Smith M, Ortiz SN, Brooks G, Thompson-Brenner H. Traditional versus virtual partial hospital programme for eating disorders: Feasibility and preliminary comparison of effects. EUROPEAN EATING DISORDERS REVIEW 2024; 32:163-178. [PMID: 37677002 DOI: 10.1002/erv.3031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Minimal research has examined teletherapy for group or intensive eating disorder (ED) treatment, particularly partial hospital programme (PHP). This study compared treatment outcomes for individuals treated before and after a pandemic-driven implementation of virtual PHP. METHOD Patients received care at ED treatment centres using the Renfrew Unified Treatment for Eating Disorders and Comorbidity. Patients treated with virtual PHP were compared to patients treated with traditional PHP. Measures of ED symptomology and behaviours, depressive symptoms, anxiety severity, anxiety sensitivity, experiential avoidance, mindfulness, and body mass index (BMI; reported for anorexia nervosa [AN] patients only) were collected at intake and discharge. Multiple regression analyses were conducted to examine the effect of treatment group on outcomes, controlling for intake score, comorbidity, discharge status, AN diagnosis, and step-down status. RESULTS Differences in treatment type were only found for binge eating frequency, with those in virtual PHP reporting significantly lower binge eating episodes at discharge than those in traditional PHP. Body mass index showed significantly less improvement in virtual PHP than in traditional PHP. CONCLUSIONS Preliminary results suggest virtual PHP is feasible and effective, potentially increasing access to evidence-based, intensive ED treatment. However, additional research is needed to establish efficacious support for weight gain among individuals with AN in virtual programs.
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Affiliation(s)
| | | | - Shelby N Ortiz
- Department of Psychology, Miami University, Oxford, OH, USA
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Rezende F, Oliveira BMPM, Poínhos R. Assessment of Intuitive Eating and Mindful Eating among Higher Education Students: A Systematic Review. Healthcare (Basel) 2024; 12:572. [PMID: 38470683 PMCID: PMC10931607 DOI: 10.3390/healthcare12050572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The role of mindful eating (ME) and intuitive eating (IE) in improving eating behavior, diet quality, and health is an area of increasing interest. OBJECTIVE The objective of this review was to identify the instruments used to assess ME and IE among higher education students and outcomes related to these dimensions. METHODS This review was carried out according to the PRISMA statement, through systematic searches in PubMed, Web of Science, PsycInfo, and Scopus. The inclusion criteria selected for higher education students, levels of ME and/or IE reported, and observational and clinical studies. The exclusion criteria selected against reviews, qualitative studies, and case studies. Quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS A total of 516 initial records were identified, from which 75 were included. Cross-sectional studies were the most common research design (86.7%). Most studies were conducted with samples that were predominantly female (90.7%), White (76.0%), aged 18 to 22 years (88.4%), with BMI < 25 kg/m2 (83.0%), and in the United States (61.3%). The Intuitive Eating Scale (IES), the Mindful Eating Questionnaire (MEQ), and their different versions were the most used instruments. The outcomes most studies included were eating behavior and disorders (77.3%), anthropometric assessments (47.8%), mental health (42.0%), and body image (40.6%). Regarding the quality of studies, 34.7% of studies were assigned a positive, 1.3% a negative, and 64.0% a neutral rate. CONCLUSIONS IES and MEQ were the most used instruments. RCT and cohort studies are scarce, and future research with a higher level of quality is needed, especially on the topics of food consumption, diet quality, and biochemical markers.
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Affiliation(s)
- Fabiane Rezende
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Rua do Campo Alegre 823, 4150-180 Porto, Portugal;
| | - Bruno M. P. M. Oliveira
- Laboratory of Artificial Intelligence and Decision Support, Institute for Systems and Computer Engineering, Technology and Science (LIIAD, INESC-TEC), 4200-465 Porto, Portugal;
| | - Rui Poínhos
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Rua do Campo Alegre 823, 4150-180 Porto, Portugal;
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Bracké K, Steegers C, van der Harst T, Pons R, Legerstee J, Dierckx B, de Nijs P, Bax-van Berkel M, van Elburg A, Hekkelaan M, Hokke J, de Jong-Zuidema H, Korthals Altes L, Lengton-van der Spil F, Luijkx J, Schuurmans F, Smeets C, van Wijk L, Woltering C, Vernooij M, Hillegers M, White T, Dieleman G. 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. Eat Weight Disord 2024; 29:13. [PMID: 38347293 PMCID: PMC10861646 DOI: 10.1007/s40519-024-01640-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/28/2024] [Indexed: 02/15/2024] Open
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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Affiliation(s)
- Katrien Bracké
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Cathelijne Steegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Tess van der Harst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Rozemarijn Pons
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Jeroen Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Bram Dierckx
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Pieter de Nijs
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | | | - Annemarie van Elburg
- Altrecht-Rintveld, Mental Health Care Organisation for Eating Disorders, Zeist, The Netherlands
| | - Marion Hekkelaan
- Department of Pediatrics, Het Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Joke Hokke
- Emergis-Ithaka, Mental Health Care Organisation for Child and Adolescent Psychiatry, Kloetinge, The Netherlands
| | - Hetty de Jong-Zuidema
- GGZ Delfland, Mental Health Care Organisation for Child and Adolescent Psychiatry, Delft, The Netherlands
| | - Lucas Korthals Altes
- LUMC-Curium, Mental Health Care Organisation for Child and Adolescent Psychiatry, Leiden, The Netherlands
| | - Farida Lengton-van der Spil
- Department for Eating Disorders, Emergis, Organisation for Mental Health and Well-Being, Goes, The Netherlands
| | - Judith Luijkx
- GGZ Westelijk Noord Brabant, Mental Health Care Organisation for Child and Adolescent Psychiatry, Roosendaal and Bergen Op Zoom, Bergen Op Zoom, The Netherlands
| | - Femke Schuurmans
- Department of Pediatrics, The Bravis Hospital, Bergen Op Zoom, The Netherlands
| | - Carien Smeets
- Department of Pediatrics, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Lia van Wijk
- Department of Pediatrics, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands
| | - Claire Woltering
- Department of Pediatrics, Het Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Meike Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Section on Social and Cognitive Developmental Neuroscience, National Institutes of Mental Health, Bethesda, MD, USA
| | - Gwen Dieleman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands.
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Lawson ML, Hisle-Gorman E, Susi A, Dorr M, Nylund CM, Chokshi B. Impact of the COVID-19 pandemic on care for anorexia and bulimia nervosa in US military-connected adolescents and young adults. Int J Eat Disord 2024; 57:376-387. [PMID: 38069451 DOI: 10.1002/eat.24105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 02/10/2024]
Abstract
OBJECTIVE This study examined the impact of the COVID-19 pandemic on healthcare engagement for anorexia nervosa (AN) and bulimia nervosa (BN) in a large, geographically diverse population. METHOD This repeated monthly, cross-sectional study queried Military Health System records of individuals aged 10-21 before and during the pandemic (February 2019-January 2022). ICD-10 codes identified encounters for AN and BN. Monthly rates of care were modeled as the number of unique individuals with an ICD-10-identified eating disorder-related encounter per month divided by the enrolled population. Poisson regression analysis evaluated rates of care stratified by eating disorder, clinical setting, and sex. RESULTS In a population of 1.76 million adolescents and young adults, 1629 individuals with AN or BN received care during the pre-pandemic period; 3256 received care during the pandemic. The monthly rate of care for females with AN during the pandemic increased in inpatient settings (adjusted relative risk [aRR]: 1.31 [1.16-1.49]) and outpatient settings (aRR: 1.42 [1.37-1.47]); monthly care rates in males with AN increased in the outpatient setting (aRR: 1.46 [1.28-1.67]). Females with BN had increased engagement in outpatient settings (aRR: 1.09 [1.03-1.16]); BN care for males showed no significant monthly changes during the pandemic period in either healthcare setting. DISCUSSION With increased rates of AN and BN disorder-related care during the pandemic, screening for eating disorder symptomatology may allow for timely diagnosis and intervention in periods of heightened stress. Pandemic-related increases in healthcare engagement may strain limited resources, emphasizing a need to expand accessibility of clinical expertise. PUBLIC SIGNIFICANCE This study indicates that monthly rates of healthcare engagement during the COVID-19 pandemic for AN and BN varied based on clinical setting and sex in an adolescent and young adult population. The increased number of individuals seeking eating disorder-related care, especially outpatient care, attributed to heightened stressors necessitates accessible professionals with eating disorder clinical expertise.
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Affiliation(s)
- Michelle L Lawson
- Department of Pediatrics, Division of Adolescent Medicine, Brooke Army Medical Center, JBSA-Fort Sam Houston, Texas, USA
| | - Elizabeth Hisle-Gorman
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Apryl Susi
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Madeline Dorr
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Cade M Nylund
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Binny Chokshi
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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12
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Huffman LG, Lawrence-Sidebottom D, Beam AB, Parikh A, Guerra R, Roots M, Huberty J. Improvements in Adolescents' Disordered Eating Behaviors in a Collaborative Care Digital Mental Health Intervention: Retrospective Observational Study. JMIR Form Res 2024; 8:e54253. [PMID: 38294855 PMCID: PMC10867747 DOI: 10.2196/54253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/14/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Young people today are exhibiting increasing rates of disordered eating behaviors, as well as eating disorders (EDs), alongside other mental and behavioral problems such as anxiety and depression. However, limited access to mental health care means that EDs, disordered eating behaviors, and comorbid mental health problems are often underdiagnosed and undertreated. Digital mental health interventions (DMHIs) offer accessible and scalable alternatives to traditional treatment modalities, but their effectiveness has not been well established among adolescents with EDs and disordered eating behaviors. OBJECTIVE This study uses data from a collaborative care pediatric DMHI to determine whether participation in a DMHI is associated with a reduction in adolescents' disordered eating behaviors. METHODS Adolescent members in care with Bend Health Inc completed the SCOFF questionnaire at baseline (before the start of care) and approximately every month during care to assess disordered eating behaviors. They also completed assessments of mental health symptoms at baseline. Member characteristics, mental health symptoms, and disordered eating behaviors of adolescents with elevated SCOFF scores at baseline (before the start of care) were compared to those of adolescents with nonelevated SCOFF scores at baseline. Members participated in web-based coaching or therapy sessions throughout the duration of mental health care. RESULTS Compared to adolescents with nonelevated SCOFF scores (n=520), adolescents with elevated SCOFF scores (n=169) were predominantly female and exhibited higher rates of elevated anxiety and depressive symptoms. SCOFF scores decreased over time in care with the DMHI for 61.4% (n=70) of adolescents with elevated SCOFF scores, and each additional month of participation was associated with greater improvements in disordered eating behaviors (F1,233=72.82; P<.001). CONCLUSIONS Our findings offer promising preliminary evidence that participation in mental health care with a collaborative care DMHI may be beneficial in the reduction of disordered eating symptoms in adolescents, including those who are experiencing comorbid anxiety and depressive symptoms.
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Affiliation(s)
| | | | | | | | | | | | - Jennifer Huberty
- Bend Health Inc, Madison, WI, United States
- FitMinded Inc LLC, Phoenix, AZ, United States
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13
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Bastoni I, Guerrini Usubini A, Gobetti M, Sanna M, Pagnoncelli G, Uboldi L, Villa V, Castelnuovo G, Sartorio A, Mendolicchio L. Let the Body Talk: Preliminary Data of an Open Trial of Dance Movement Therapy for Eating Disorders. J Clin Med 2023; 13:5. [PMID: 38202012 PMCID: PMC10779718 DOI: 10.3390/jcm13010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND There is growing support for considering Dance Movement Therapy (DMT) as an effective approach to improving physical and psychological symptoms in eating disorders (ED), but additional evidence is needed. The current study aims to investigate the effectiveness of a DMT intervention for inpatients with ED during an in-hospital rehabilitation program for ED in reducing emotion dysregulation and alexithymia and improving interoceptive awareness. METHODS Forty-nine consecutive inpatient young women with ED (aged between 18 and 34 years) recruited from a clinical center for the rehabilitation of obesity and ED received four group sessions of DMT intervention. All participants completed the Difficulties in Emotion Regulation Scale (DERS), the Toronto Alexithymia Scale (TAS), and the Multidimensional Assessment of Interoceptive Awareness Scale (MAIA) before (Time 0) and after the intervention (Time 1). Paired-sample t-tests were run to assess differences between Time 0 to Time 1. RESULTS From pre-to-post interventions, there was a significant reduction in the means of all of the subscales of DERS, suggesting an improvement in emotion regulation competencies, with the only exception for difficulties in awareness that increased (p = 0.016). We also found a significant reduction in alexithymia, as proved by significant differences in all of the subscales and the total score of TAS (p < 0.001), and significant improvements in interoceptive awareness as suggested by increased scores of the noticing (p = 0.043), emotional awareness (p < 0.001), body listening (p < 0.001), and trusting (p < 0.001) subscales of MAIA. CONCLUSION Overall, our results point towards the efficacy of dance/movement in reducing symptoms of eating disorders. Our findings also suggest that dancing can be considered a useful intervention to increase emotional regulation, reduce alexithymia, and enhance interoceptive awareness.
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Affiliation(s)
- Ilaria Bastoni
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy; (I.B.); (V.V.); (G.C.)
- Centro Arti Terapie, 20122 Milan, Italy; (M.S.); (G.P.); (L.U.)
| | - Anna Guerrini Usubini
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy; (I.B.); (V.V.); (G.C.)
| | - Maria Gobetti
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Mila Sanna
- Centro Arti Terapie, 20122 Milan, Italy; (M.S.); (G.P.); (L.U.)
| | - Glenda Pagnoncelli
- Centro Arti Terapie, 20122 Milan, Italy; (M.S.); (G.P.); (L.U.)
- Politecnico di Milano—METID: Metodi e Tecnologie Innovative per la Didattica, 20133 Milan, Italy
| | - Laura Uboldi
- Centro Arti Terapie, 20122 Milan, Italy; (M.S.); (G.P.); (L.U.)
| | - Valentina Villa
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy; (I.B.); (V.V.); (G.C.)
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy; (I.B.); (V.V.); (G.C.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy;
| | - Leonardo Mendolicchio
- Division of Eating and Nutrition Disorders, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 28824 Verbania, Italy;
- Experimental Laboratory for Metabolic Neurosciences, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 28824 Verbania, Italy
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14
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Putra IGNE, Polden M, Wareing L, Robinson E. Acceptability and perceived harm of calorie labeling and other obesity policies: A cross-sectional survey study of UK adults with eating disorders and other mental health conditions. Int J Eat Disord 2023; 56:2049-2061. [PMID: 37507841 PMCID: PMC10947290 DOI: 10.1002/eat.24031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVE We assessed perceptions of recently proposed UK obesity policies (mandatory calorie labeling, banning of advertisements of unhealthy food and drinks online and before 9 pm on TV, and banning "buy one get one free" deals for unhealthy food and drinks) in people with an eating disorder (ED) and other mental health conditions. METHOD A total of 1273 participants with a self-reported lifetime mental health condition (N = 583 with an ED) completed an online survey in September-November 2022. Multinomial logistic regression was used to examine support for and potential adverse effects of policies in participants with and without an ED. A qualitative analysis of the potential effects of the policy on current ED symptoms was also conducted to better understand how and why policies may be damaging or beneficial. RESULTS Participants with an ED had a lower level of support for the implementation of the calorie labeling policy compared to those without an ED (43% vs. 58%). Half of the participants with an ED (55%) reported that labeling may worsen their ED symptoms. Qualitative data indicated perceived potential harm (e.g., a gateway to relapse, negative effects on mood) and perceived benefits (e.g., feeling informed and reassured) of calorie labeling in participants with an ED. No differences in support or perceived harms of the other two policies were observed between participants with versus without an ED. DISCUSSION Future studies are warranted to explore the potential effects of calorie labeling and how to mitigate negative impacts on people with an ED. PUBLIC SIGNIFICANCE This research is the first to assess the perceptions of UK obesity-related policies in people with an ED and other mental health conditions. Participants with an ED (vs. without) were more likely to disagree with the government implementing the calorie labeling policy. These findings highlight the potentially harmful effects of calorie labeling in people with an ED and the need for future research to understand how to mitigate negative impacts.
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Affiliation(s)
| | - Megan Polden
- Department of Primary Care and Mental Health, Institute of Population HealthUniversity of LiverpoolLiverpoolUK
- NIHR Applied Research Collaboration North West CoastLiverpoolUK
| | | | - Eric Robinson
- Department of Psychology, Institute of Population HealthUniversity of LiverpoolLiverpoolUK
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15
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Bertollo AG, Braga GDC, Tonin PT, Luzardo AR, Bagatini MD, Ignácio ZM. The Impact of Stress from Social Isolation during the COVID-19 Pandemic on Psychiatric Disorders: An Analysis from the Scientific Literature. Brain Sci 2023; 13:1414. [PMID: 37891783 PMCID: PMC10605406 DOI: 10.3390/brainsci13101414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
The COVID-19 pandemic generated, in addition to severe symptoms, hospitalizations and deaths worldwide, as well as stress from the fear of the disease and social uncertainties, from restriction measures and social isolation. Stress from social isolation impacts mental health, aggravating existing conditions and triggering neuropsychiatric symptoms in individuals with biopsychosocial vulnerability. During and immediately after the period of social restriction imposed by the pandemic, the scientific community carried out several research protocols. These revealed results that relevantly demonstrate the harmful effect of the stress induced by the pandemic situation. This narrative review reports and discusses research results demonstrating impairments in psychiatric disorders such as autism spectrum disorder, dementia, eating disorders, schizophrenia, anxiety, and depression. In this sense, the community has identified a significant negative influence of social isolation on the mental health of individuals through the modification of individual routines and the absence of social interactions. Moreover, the community identified perceived differences related to the impacts on men and women. In addition to studies showing the effect of social isolation on disorders, an evaluation of protocols with some possible therapeutic intervention strategies during times of social restriction was developed.
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Affiliation(s)
- Amanda Gollo Bertollo
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó 89815-899, SC, Brazil;
| | - Geórgia de Carvalho Braga
- Cell Culture Laboratory, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó 89815-899, SC, Brazil; (G.d.C.B.); (M.D.B.)
| | | | - Adriana Remião Luzardo
- Research Laboratory in Health Management, Innovation and Technologies, Graduate Program in Nursing, Federal University of Fronteira Sul, Chapecó 89815-899, SC, Brazil;
| | - Margarete Dulce Bagatini
- Cell Culture Laboratory, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó 89815-899, SC, Brazil; (G.d.C.B.); (M.D.B.)
| | - Zuleide Maria Ignácio
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó 89815-899, SC, Brazil;
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16
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Raffoul A, Beccia AL, Jackson DA, Sarda V, Hart JE, Chavarro JE, Austin SB. Associations between weight discrimination and the use of potentially harmful dietary supplements during the COVID-19 pandemic in the United States. Soc Sci Med 2023; 335:116232. [PMID: 37708694 PMCID: PMC10567056 DOI: 10.1016/j.socscimed.2023.116232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
The dietary supplements industry disproportionately markets potentially harmful products promising weight loss, cleansing/detoxing, and boosted energy and immunity to women. The COVID-19 pandemic heightened consumer concerns around health and body weight, which may have increased women's risks of using supplements, particularly if they had a higher weight and experienced weight discrimination. This study aimed to estimate inequities in prevalence and change in use of weight-loss, cleanse/detox, immunity, and energy supplements in the first year of the pandemic and to assess the extent to which the relationship between weight and supplement use differs across discrimination experiences. We drew upon longitudinal data from cisgender women in the U.S. COVID-19 Pandemic Substudy of the Nurses' Health Study II and 3 and Growing Up Today Study cohorts, collected over 5 waves from April/May 2020 to April 2021 (N = 51,814). Modified Poisson generalized estimating equation models, adjusted for age, cohort, race/ethnicity, wave, and Census region, estimated the relative excess risk due to interaction (RERI) between weight status and weight discrimination on prevalence of supplement use. Weight status categories were derived from body mass index (BMI), and weight discrimination was assessed using the attributions item of the Everyday Discrimination Scale. Baseline prevalence of supplement use was 2.7% for weight-loss, 3.3% for cleanse/detox, 4.2% for energy, and 22.6% for immune. Respondents with BMIs of 25-29.9 kg/m2 and 30-34.9 kg/m2 who experienced weight discrimination had RERI values of 0.89 (95% CI 0.14, 1.65) and 1.00 (95% CI 0.25, 1.75) for weight-loss and 0.57 (95% CI 0.13, 1.02) and 0.60 (95% CI 0.19, 1.01) for energy supplements, respectively, indicating this group had excess risk of use compared to lower BMI respondents who experienced no weight discrimination. The findings demonstrate the disproportionate impact of weight discrimination on use of potentially harmful supplements among cisgender women with higher weights during the pandemic.
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Affiliation(s)
- Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Ariel L Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
| | - Destiny A Jackson
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Jorge E Chavarro
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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17
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Caldiroli A, La Tegola D, Manzo F, Scalia A, Affaticati LM, Capuzzi E, Colmegna F, Argyrides M, Giaginis C, Mendolicchio L, Buoli M, Clerici M, Dakanalis A. The Impact of the COVID-19 Pandemic on Binge Eating Disorder: A Systematic Review. Nutrients 2023; 15:3777. [PMID: 37686811 PMCID: PMC10490470 DOI: 10.3390/nu15173777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/18/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of this systematic review was to synthesise the impact of the COVID-19 pandemic on binge eating disorder (BED) the new onset and course. Inclusion criteria: original articles and BED diagnosis; and the main outcomes: relationships between the COVID-19 pandemic and the new onset/clinical changes in BED, and specific results for BED. Exclusion criteria: mixed/inaccurate diagnoses and articles not written in English. We searched four databases and one registry until 5 May 2023. The quality appraisal was conducted using the Effective Public Health Practice Project (EPHPP) tool. Twelve studies with 4326 participants were included. All studies were observational with nine cross-sectional and three longitudinal. Four of the included studies investigated new-onset BED, while eight examined the BED clinical course of patients with a previous diagnosis. With the exception of one study, the available literature indicates both an increase in BED diagnoses and a clinical worsening during COVID-19. Major limitations include study quality (weak-to-moderate) and high heterogeneity in terms of pandemic phase, population, geographical areas, and psychometric tools. Our findings indicate that BED patients are particularly vulnerable to events characterised by social distancing and over-worry, and should be, therefore, carefully monitored. Further studies are needed to corroborate our findings, implement preventive strategies, and promote personalised treatments. PROSPERO registration number: CRD42023434106.
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Affiliation(s)
- Alice Caldiroli
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Davide La Tegola
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Francesca Manzo
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Alberto Scalia
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Letizia Maria Affaticati
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Enrico Capuzzi
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Fabrizia Colmegna
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Marios Argyrides
- Department of Psychology, Neapolis University Pafos, Paphos 8042, Cyprus;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece;
| | - Leonardo Mendolicchio
- Istituto Auxologico Italiano IRCCS, U.O. dei Disturbi del Comportamento Alimentare, Ospedale San Giuseppe, 28824 Piancavallo, Italy;
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy;
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Massimo Clerici
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Antonios Dakanalis
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
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18
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Joffe AR, Elliott A. Long COVID as a functional somatic symptom disorder caused by abnormally precise prior expectations during Bayesian perceptual processing: A new hypothesis and implications for pandemic response. SAGE Open Med 2023; 11:20503121231194400. [PMID: 37655303 PMCID: PMC10467233 DOI: 10.1177/20503121231194400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/27/2023] [Indexed: 09/02/2023] Open
Abstract
This review proposes a model of Long-COVID where the constellation of symptoms are in fact genuinely experienced persistent physical symptoms that are usually functional in nature and therefore potentially reversible, that is, Long-COVID is a somatic symptom disorder. First, we describe what is currently known about Long-COVID in children and adults. Second, we examine reported "Long-Pandemic" effects that create a risk for similar somatic symptoms to develop in non-COVID-19 patients. Third, we describe what was known about somatization and somatic symptom disorder before the COVID-19 pandemic, and suggest that by analogy, Long-COVID may best be conceptualized as one of these disorders, with similar symptoms and predisposing, precipitating, and perpetuating factors. Fourth, we review the phenomenon of mass sociogenic (functional) illness, and the concept of nocebo effects, and suggest that by analogy, Long-COVID is compatible with these descriptions. Fifth, we describe the current theoretical model of the mechanism underlying functional disorders, the Bayesian predictive coding model for perception. This model accounts for moderators that can make symptom inferences functionally inaccurate and therefore can explain how to understand common predisposing, precipitating, and perpetuating factors. Finally, we discuss the implications of this framework for improved public health messaging during a pandemic, with recommendations for the management of Long-COVID symptoms in healthcare systems. We argue that the current public health approach has induced fear of Long-COVID in the population, including from constant messaging about disabling symptoms of Long-COVID and theorizing irreversible tissue damage as the cause of Long-COVID. This has created a self-fulfilling prophecy by inducing the very predisposing, precipitating, and perpetuating factors for the syndrome. Finally, we introduce the term "Pandemic-Response Syndrome" to describe what previously was labeled Long-COVID. This alternative perspective aims to stimulate research and serve as a lesson learned to avoid a repeat performance in the future.
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Affiliation(s)
- Ari R Joffe
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - April Elliott
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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19
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Monthuy-Blanc J, Faghihi U, Fardshad MNG, Corno G, Iceta S, St-Pierre MJ, Bouchard S. When Eating Intuitively Is Not Always a Positive Response: Using Machine Learning to Better Unravel Eaters Profiles. J Clin Med 2023; 12:5172. [PMID: 37629214 PMCID: PMC10455794 DOI: 10.3390/jcm12165172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The aim of the present study was to identify eaters profiles using the latest advantages of Machine Learning approach to cluster analysis. METHODS A total of 317 participants completed an online-based survey including self-reported measures of body image dissatisfaction, bulimia, restraint, and intuitive eating. Analyses were conducted in two steps: (a) identifying an optimal number of clusters, and (b) validating the clustering model of eaters profile using a procedure inspired by the Causal Reasoning approach. RESULTS This study reveals a 7-cluster model of eaters profiles. The characteristics, needs, and strengths of each eater profile are discussed along with the presentation of a continuum of eaters profiles. CONCLUSIONS This conceptualization of eaters profiles could guide the direction of health education and treatment interventions targeting perceptual and eating dimensions.
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Affiliation(s)
- Johana Monthuy-Blanc
- Unité de Recherche Loricorps, Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, (CR-IUSMM), 7331, Rue Hochelaga, Montreal, QC H1N 3V2, Canada
- Département de Sciences de l’Éducation, Université du Québec à Trois-Rivières, 3351, Boulevard des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Usef Faghihi
- Unité de Recherche Loricorps, Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, (CR-IUSMM), 7331, Rue Hochelaga, Montreal, QC H1N 3V2, Canada
- Département de Mathématiques et d’Informatique, Université du Québec à Trois-Rivières, 3063, Ringuet, Trois-Rivières, QC G8Z 4M3, Canada
| | - Mahan Najafpour Ghazvini Fardshad
- Unité de Recherche Loricorps, Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, (CR-IUSMM), 7331, Rue Hochelaga, Montreal, QC H1N 3V2, Canada
- Département de Mathématiques et d’Informatique, Université du Québec à Trois-Rivières, 3063, Ringuet, Trois-Rivières, QC G8Z 4M3, Canada
| | - Giulia Corno
- Unité de Recherche Loricorps, Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, (CR-IUSMM), 7331, Rue Hochelaga, Montreal, QC H1N 3V2, Canada
- Département de Sciences de l’Éducation, Université du Québec à Trois-Rivières, 3351, Boulevard des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Sylvain Iceta
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, QC G1V 0A6, Canada
| | - Marie-Josée St-Pierre
- Unité de Recherche Loricorps, Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, (CR-IUSMM), 7331, Rue Hochelaga, Montreal, QC H1N 3V2, Canada
- Département de Sciences de l’Éducation, Université du Québec à Trois-Rivières, 3351, Boulevard des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Stéphane Bouchard
- Unité de Recherche Loricorps, Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, (CR-IUSMM), 7331, Rue Hochelaga, Montreal, QC H1N 3V2, Canada
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, 283, Boul Alexandre-Taché, Gatineau, QC J8X 3X7, Canada
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20
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Wiśniewski OW, Czyżniewski B, Żukiewicz-Sobczak W, Gibas-Dorna M. Nutritional Behavior in European Countries during COVID-19 Pandemic-A Review. Nutrients 2023; 15:3451. [PMID: 37571387 PMCID: PMC10420667 DOI: 10.3390/nu15153451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/23/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
COVID-19 is highly linked with hyperinflammation and dysfunction of the immune cells. Studies have shown that adequate nutrition, a modifiable factor affecting immunity and limiting systemic inflammation, may play an adjunct role in combating the negative consequences of SARS-CoV-2 infection. Due to the global lockdown conditions, the COVID-19 pandemic has contributed, among others, to restrictions on fresh food availability and changes in lifestyle and eating behaviors. The aim of this paper was to review the data regarding eating habits in European countries within the general population of adults and some specific subpopulations, including obese, diabetic, and psychiatric patients, during the COVID-19 pandemic. The PubMed database and the official websites of medical organizations and associations were searched for the phrases "COVID" and "eating habits". Papers regarding the pediatric population, non-European countries, presenting aggregated data from different countries worldwide, and reviews were excluded. During the COVID-19 pandemic, unhealthy lifestyles and eating behaviors were commonly reported. These included increased snacking, intake of caloric foods, such as sweets, pastries, and beverages, and a decline in physical activity. Data suggest that poor eating habits that create a positive energy balance have persisted over time as an additional post-COVID negative consequence.
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Affiliation(s)
- Oskar Wojciech Wiśniewski
- Department of Cardiology-Intensive Therapy and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland
- Department of Nutrition and Food, Faculty of Health Sciences, Calisia University, 62-800 Kalisz, Poland;
| | - Bartłomiej Czyżniewski
- Faculty of Medicine, Collegium Medicum, University of Zielona Gora, 28 Zyty Street, 65-046 Zielona Gora, Poland;
| | - Wioletta Żukiewicz-Sobczak
- Department of Nutrition and Food, Faculty of Health Sciences, Calisia University, 62-800 Kalisz, Poland;
| | - Magdalena Gibas-Dorna
- Collegium Medicum, Institute of Health Sciences, University of Zielona Gora, 28 Zyty Street, 65-046 Zielona Gora, Poland
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21
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Ganson KT, Cuccolo K, Nagata JM. Loneliness is associated with eating disorders among a national sample of U.S. college students during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-5. [PMID: 37486743 DOI: 10.1080/07448481.2023.2232872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 05/25/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE To identify the association between loneliness and eating disorder symptomatology among a national sample of U.S. college students during COVID-19. PARTICIPANTS Cross-sectional data from the 2020-2021 Healthy Minds Study (N = 96,645) were analyzed. METHODS Loneliness was measured using the UCLA 3-item Loneliness Scale and eating disorder symptomology was measured using the SCOFF questionnaire. Multiple modified Poisson regression analyses were conducted, adjusting for confounding variables. RESULTS Greater loneliness was associated with both a positive eating disorder screen (risk ratio [RR] 1.09, 95% confidence interval [CI] 1.09-1.10) and greater number of eating disorder symptoms (RR 1.07, 95% CI 1.06-1.08). Gender modified this relationship, and men who endorsed greater loneliness had higher risk of eating disorder symptomatology compared to women. CONCLUSIONS Loneliness during the COVID-19 pandemic was associated with a greater risk of eating disorder symptomatology among college students. Findings underscore the need for social support and eating disorders programming on college campuses.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kelly Cuccolo
- Department of Psychology, Alma College, Alma, MI, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, CA, USA
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22
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Esmaeeli ST, Rahimi Z, Saeed F, Shoib S. COVID-19 induced anorexia nervosa: A case series and brief review of literature. Clin Case Rep 2023; 11:e7534. [PMID: 37323292 PMCID: PMC10264923 DOI: 10.1002/ccr3.7534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/08/2023] [Accepted: 05/28/2023] [Indexed: 06/17/2023] Open
Abstract
Key Clinical Message This article emphasizes that patients presenting with COVID-19 infection especially presenting with predominantly gastrointestinal symptoms and a history of eating disorder or even other mental disorders should be evaluated thoroughly and differential diagnoses should be considered. Clinicians should keep in mind that eating disorders may happen after COVID infection or vaccination. Abstract The emergence and global spread of the 2019 novel coronavirus (COVID-19) have caused a significant mental health burden on communities around the world. Factors related to COVID-19 affect mental health in the general community, but may have more adverse effects on individuals with pre-existing mental illnesses. Additionally with the new living conditions and increased focus on hand hygiene and fear of contracting COVID-19, depression, anxiety, and obsessive-compulsive disorder (OCD) are more likely to be exacerbated. Eating disorders such as anorexia nervosa (AN) have exhibited an alarming increase due to social pressure especially through social media. Also, many patients reported relapses since the commencement of the COVID-19 pandemic. We report five cases of AN that developed or exacerbated after COVID-19 infection. Four patients have newly developed (AN) and one case relapsed after COVID-19 infection. Also, one of the patient's symptoms exacerbated after remission following a COVID-19 vaccine shot. The patients were managed medical and non-medically. Three of cases have reported improvements while two other cases were lost because of poor compliance. It might be possible that people with history of eating disorder, or other mental disorders may be more susceptible to newly develop or exacerbate eating disorders after COVID-19 infection especially when symptoms are gastrointestinal dominant. There is currently minimal evidence on the specific risk of COVID-19 infection in patients with AN and reporting cases of AN after COVID-19 infection could help learn the risk, prevent and manage patients. Clinicians should keep in mind that eating disorders may happen after COVID infection or vaccination.
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Affiliation(s)
- Soode Tajik Esmaeeli
- Department of Psychiatry, Minimally Invasive Surgery Research Center, Rasool‐e Akram Hospital, Mental Health Research Center, Psychosocial Health Research Institute, School of MedicineIran University of Medical SciencesTehranIran
| | - Zahra Rahimi
- School of MedicineIran University of MedicalTehranIran
| | - Fahimeh Saeed
- Psychosis Research CenterUniversity of Social Welfare and Rehabilitation SciencesTehranIran
| | - Sheikh Shoib
- Department of Health ServicesJawahar Lal Nehru Memorial HospitalSrinagarKashmirIndia
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23
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Borsarini B, Pappaianni E, Micali N. Locked down with my eating disorder: a retrospective study on the impact of COVID-19 lockdown on adolescents with eating disorders. J Eat Disord 2023; 11:71. [PMID: 37165458 PMCID: PMC10171150 DOI: 10.1186/s40337-023-00792-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/21/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Negative effects of COVID-19 lockdowns have been reported in adult patients with feeding and eating disorders (FED) whereas evidence of its impact on young clinical populations is still limited and somewhat inconsistent. The present study aims to investigate the effect of the first COVID-19 lockdown on a range of FED symptoms in children and adolescents: (a) already receiving treatment in our specialist service for FED when the pandemic hit, and (b) prospectively evaluated in our service from October 2020 to July 2021. METHODS Out of sixty-one eligible patients with a broad spectrum of FED invited, forty-five young patients (aged 11-18) consented to participate and were included. An ad-hoc survey, consisting of open questions, multiple choice questions, yes/no questions, and a symptoms checklist, was administered online. RESULTS About half of the participants (46.7%) reported a positive effect of lockdown on FED symptomatology. Patients with anorexia nervosa (AN) reported the highest rate of symptomatology worsening (58.6%). Younger patients (11-13 years) showed a greater improvement of symptoms compared to older ones (14-18 years of age). COVID-19 lockdown was identified as the precipitating factor for FED onset in 60.7% of newly evaluated patients. CONCLUSIONS Evidence from our investigation points out that although the COVID-19 pandemic was a precipitating factor for a FED for many active and newly referred patients, it had a positive impact on youth who were already in treatment and younger participants.
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Affiliation(s)
- Bianca Borsarini
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Eating and feeding Disorders Research (CEDaR), Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Maglevænget 32, 2750, Ballerup, Denmark
| | - Edoardo Pappaianni
- Center for Eating and feeding Disorders Research (CEDaR), Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Maglevænget 32, 2750, Ballerup, Denmark
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Center for Eating and feeding Disorders Research (CEDaR), Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Maglevænget 32, 2750, Ballerup, Denmark.
- Great Ormond Street Institute of Child Health, University College London, London, UK.
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24
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Dedoni S, Scherma M, Camoglio C, Siddi C, Fratta W, Fadda P. Anaplastic Lymphoma Kinase Receptor: Possible Involvement in Anorexia Nervosa. Nutrients 2023; 15:2205. [PMID: 37432348 DOI: 10.3390/nu15092205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 07/12/2023] Open
Abstract
The pathophysiology of Anorexia Nervosa (AN) has not been fully elucidated. Anaplastic lymphoma kinase (ALK) receptor is a protein-tyrosine kinase mainly known as a key oncogenic driver. Recently, a genetic deletion of ALK in mice has been found to increase energy expenditure and confers resistance to obesity in these animals, suggesting its role in the regulation of thinness. Here, we investigated the expression of ALK and the downstream intracellular pathways in female rats subjected to the activity-based anorexia (ABA) model, which reproduces important features of human AN. In the hypothalamic lysates of ABA rats, we found a reduction in ALK receptor expression, a downregulation of Akt phosphorylation, and no change in the extracellular signal-regulated protein kinases 1 and 2 (ERK1/2) phosphorylation. After the recovery from body weight loss, ALK receptor expression returned to the control baseline values, while it was again suppressed during a second cycle of ABA induction. Overall, this evidence suggests a possible involvement of the ALK receptor in the pathophysiology of AN, that may be implicated in its stabilization, resistance, and/or its exacerbation.
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Affiliation(s)
- Simona Dedoni
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Science, University of Cagliari, 09124 Cagliari, Italy
| | - Maria Scherma
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Science, University of Cagliari, 09124 Cagliari, Italy
| | - Chiara Camoglio
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Science, University of Cagliari, 09124 Cagliari, Italy
| | - Carlotta Siddi
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Science, University of Cagliari, 09124 Cagliari, Italy
| | - Walter Fratta
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Science, University of Cagliari, 09124 Cagliari, Italy
| | - Paola Fadda
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Science, University of Cagliari, 09124 Cagliari, Italy
- Neuroscience Institute, Section of Cagliari, National Research Council of Italy (CNR), 09042 Cagliari, Italy
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25
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Melisse B, Berg EVD, Jonge MD, Blankers M, Furth EV, Dekker J, Beurs ED. Efficacy of Web-Based, Guided Self-help Cognitive Behavioral Therapy-Enhanced for Binge Eating Disorder: Randomized Controlled Trial. J Med Internet Res 2023; 25:e40472. [PMID: 37126386 PMCID: PMC10186189 DOI: 10.2196/40472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/07/2022] [Accepted: 03/08/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Owing to the gap between treatment supply and demand, there are long waiting periods for patients with binge eating disorder, and there is an urgent need to increase their access to specialized treatment. Guided self-help cognitive behavioral therapy-enhanced (CBT-E) may have great advantages for patients if its efficacy can be established. OBJECTIVE The aim of this study was to examine the efficacy of guided self-help CBT-E compared with that of a delayed-treatment control condition. METHODS A single-blind 2-arm randomized controlled trial was designed to evaluate guided self-help CBT-E according to an intention-to-treat analysis. A total of 180 patients were randomly assigned to guided self-help CBT-E (n=90, 50%) or the delayed-treatment control condition (n=90, 50%) for which guided self-help CBT-E was provided after the initial 12-week delay. The primary outcome was reduction in binges. The secondary outcome was full recovery at the end of treatment, as measured using the Eating Disorder Examination during the last 4 weeks of treatment. A linear mixed model analysis was performed to compare treatment outcomes at the end of treatment. A second linear mixed model analysis was performed to measure between- and within-group effects for up to 24 weeks of follow-up. The Eating Disorder Examination-Questionnaire and clinical impairment assessment were conducted before and after treatment and during follow-up. In addition, dropout rates were assessed in both conditions. RESULTS During the last 4 weeks of treatment, objective binges reduced from an average of 19 (SD 16) to 3 (SD 5) binges, and 40% (36/90) showed full recovery in the guided self-help CBT-E group. Between-group effect size (Cohen d) was 1.0 for objective binges. At follow-up, after both groups received treatment, there was no longer a difference between the groups. Of the 180 participants, 142 (78.9%) completed treatment. The overall treatment dropout appeared to be associated with gender, level of education, and number of objective binges at baseline but not with treatment condition. CONCLUSIONS This is the first study to investigate the efficacy of guided self-help CBT-E. Guided self-help CBT-E appeared to be an efficacious treatment. This study's findings underscore the international guidelines recommending this type of treatment for binge eating disorder. TRIAL REGISTRATION Netherlands Trial Registry (NTR) NL7994; https://trialsearch.who.int/Trial2.aspx?TrialID=NL7994. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-020-02604-1.
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Affiliation(s)
- Bernou Melisse
- Novarum Center for Eating Disorders, Amstelveen, Netherlands
- Section Clinical Psychology, Leiden University, Leiden, Netherlands
| | | | - Margo de Jonge
- Novarum Center for Eating Disorders, Amstelveen, Netherlands
| | - Matthijs Blankers
- Research Department, Arkin Mental Health Institute, Amsterdam, Netherlands
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
- Department of Psychiatry, Location AMC, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Eric van Furth
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - Jack Dekker
- Research Department, Arkin Mental Health Institute, Amsterdam, Netherlands
| | - Edwin de Beurs
- Section Clinical Psychology, Leiden University, Leiden, Netherlands
- Research Department, Arkin Mental Health Institute, Amsterdam, Netherlands
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26
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Mizumoto Y, Sasaki Y, Sunakawa H, Tanese S, Shinohara R, Kurokouchi T, Sugimoto K, Seto M, Ishida M, Itagaki K, Yoshida Y, Namekata S, Takahashi M, Harada I, Sasaki S, Saito K, Toguchi Y, Hakosima Y, Inazaki K, Yoshimura Y, Usami M. Current situation and clinical burden of pediatricians for children with eating disorders during the COVID-19 pandemic. Glob Health Med 2023; 5:122-124. [PMID: 37128225 PMCID: PMC10130541 DOI: 10.35772/ghm.2022.01034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 03/12/2023] [Accepted: 03/20/2023] [Indexed: 05/03/2023]
Abstract
During the COVID-19 pandemic, the incidence of eating disorders (ED) has increased not only in Japan but also worldwide. This online survey for pediatricians showed that caregivers tend to visit specific pediatric institutions or child psychiatry departments when children under junior high school age develop eating disorders. There are few pediatric institutions regarding treatment acceptance for children with ED. Of the 34 respondents, 16 (47.1%) answered that the number of visits for children with eating disorders had "stayed the same", one answered it had "decreased" and 17 (50.0%) answered it had "increased" or "increased very much". In addition, 28 of the 34 respondents (82.3%) experienced difficulties with psychotherapy for children with ED. For treating children with ED, pediatricians usually conducted physical examination and have some clinical burden. ED are increasing in the COVID-19 pandemic. Because children with severe ED need to be hospitalized, child and adolescent psychiatric wards are overcrowded and some children with other mental disorders can't be admitted.
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Affiliation(s)
- Yuki Mizumoto
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
- Clinical Center of Children's Mental Health, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Yoshinori Sasaki
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
- Department of Psychiatry and Behavioral Science, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Hikaru Sunakawa
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Shuichi Tanese
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Rena Shinohara
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Toshinari Kurokouchi
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Kaori Sugimoto
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Manao Seto
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Masahiro Ishida
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kotoe Itagaki
- Department of Clinical psychology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Yukino Yoshida
- Department of Clinical psychology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Saori Namekata
- Department of Clinical psychology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Momoka Takahashi
- Clinical Center of Children's Mental Health, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Ikuhiro Harada
- Department of Social worker, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Shoko Sasaki
- Department of Psychiatry, Kansai Rosai Hospital, hyogo, Japan
| | - Kiyoshi Saito
- Department of Psychiatry, Narimasu Kosei Hospital, Tokyo, Japan
| | - Yusuke Toguchi
- Department of Psychiatry, Komagino Hospital, Tokyo, Japan
| | - Yuki Hakosima
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Kumi Inazaki
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Yuta Yoshimura
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
- Department of Clinical psychology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Masahide Usami
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
- Clinical Center of Children's Mental Health, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Address correspondence to:Masahide Usami, Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba 272- 8516, Japan. E-mail:
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27
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Straface E, Jacobis ITD, Capriati T, Pretelli I, Grandin A, Mascolo C, Vona R, Gambardella L, Cittadini C, Villani A, Marchili MR. The impact of the COVID-19 pandemic on eating disorders risk and symptoms: a retrospective study. Ital J Pediatr 2023; 49:50. [PMID: 37101237 PMCID: PMC10132438 DOI: 10.1186/s13052-023-01443-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 03/14/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Social distancing and quarantine imposed by the authority during the COVID-19 pandemic caused restrictions, which had a negative impact on eating behavior, especially among adolescents. We proposed a retrospective study aimed to evaluate the effect of the COVID-19 pandemic on eating disorders risk and symptoms. METHODS In this study, a group of 127 pediatric patients (117 females and 10 males) with eating disorders admitted to the Bambino Gesù Children's Hospital of Rome (Italy), in the period between August 2019 and April 2021, was analyzed. All patient data were collected from patients' electronic medical records. RESULTS We found that 80.3% of patients were at the onset of eating disorders and that 26% of patients had familiarity for psychotic disorders. Often these patients had comorbidities and alterations in blood parameters such as leukocytopenia, neutropenia, hypovitaminosis and hormonal problems that could affect their future. CONCLUSIONS Our findings could provide a framework for developing clinical and educational interventions to mitigate the short- and long-term negative impact of the pandemic on adolescent future health.
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Affiliation(s)
- Elisabetta Straface
- Center for Gender-Specific Medicine, Biomarkers Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
- Biomarkers Unit, Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena, Rome, 299 - 00161, Italy.
| | - Isabella Tarissi De Jacobis
- Emergency Acceptance and General Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, Rome, 00165, Italy.
| | - Teresa Capriati
- Gastroenterology and Nutritional Rehabilitation, Bambino Gesù Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, Rome, 00165, Italy
| | - Italo Pretelli
- Anorexia and Eating Disorder Unit, Child and Adolescent Psichiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, Rome, 00165, Italy
| | - Annalisa Grandin
- Emergency Acceptance and General Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, Rome, 00165, Italy
| | - Cristina Mascolo
- Pediatric Academic Department, University of Rome Tor Vergata, Via Cracovia 50, Rome, 00133, Italy
| | - Rosa Vona
- Center for Gender-Specific Medicine, Biomarkers Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy
| | - Lucrezia Gambardella
- Center for Gender-Specific Medicine, Biomarkers Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy
| | - Camilla Cittadini
- Center for Gender-Specific Medicine, Biomarkers Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy
| | - Alberto Villani
- Emergency Acceptance and General Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, Rome, 00165, Italy
| | - Maria Rosaria Marchili
- Emergency Acceptance and General Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, Rome, 00165, Italy
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28
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Novack K, Dufour R, Picard L, Taddeo D, Nadeau PO, Katzman DK, Booij L, Chadi N. Canadian pediatric eating disorder programs and virtual care during the COVID-19 pandemic: a mixed-methods approach to understanding clinicians' perspectives. Ann Gen Psychiatry 2023; 22:16. [PMID: 37101241 PMCID: PMC10132795 DOI: 10.1186/s12991-023-00443-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 03/26/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND As a result of the public health measures put in place during the COVID-19 pandemic in Canada, many health services, including those for the treatment of eating disorders, were provided at a distance. This study aims to describe the adaptations made in specialized pediatric eating disorder programs in Canada and the impact of these adaptations on health professionals' experience of providing care. METHODS A mixed-methods design was used to survey healthcare professionals working in specialized pediatric eating disorder programs about adaptations to treatment made during the pandemic and the impact of these adaptations on their experience of providing care. Data were collected between October 2021 and March 2022 using a cross-sectional survey comprising 25 questions and via semi-structured interviews. Quantitative data were summarized using descriptive statistics and qualitative data were interpreted using qualitative content analysis. RESULTS Eighteen healthcare professionals in Canada completed the online survey, of whom six also participated in the semi-structured interviews. The cross-sectional survey confirmed that, unlike in pre-pandemic times, the majority of participants provided medical care (15/18) and mental health care (17/18) at a distance during the pandemic, with most participants using telephone (17/18) and videoconferencing (17/18). Most (16/18) health professionals indicated that virtual care would continue to be used as a tool in pediatric ED treatment after the pandemic. Participants used a combination of virtual and in-person care, with most reporting weighing patients both in clinic (16/18) and virtually (15/18). Qualitative content analysis generated five themes: (1) responding to increased demand with insufficient resources; (2) adapting to changes in care due to the COVID-19 pandemic; (3) dealing with uncertainty and apprehension; (4) virtual care as an acceptable and useful clinical tool, and (5) optimal conditions and future expectations. Most interview participants (5/6) had globally positive views of virtual care. CONCLUSIONS Providing virtual multidisciplinary treatment for children and adolescents with eating disorders seemed feasible and acceptable to professionals during the pandemic. Moving forward, focusing on health professionals' perspectives and providing appropriate training in virtual interventions is essential given their central role in successful implementation and continued use of virtual and hybrid care models.
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Affiliation(s)
- Kaylee Novack
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Canada
| | - Rachel Dufour
- Department of Psychology, Concordia University, Montreal, Canada
| | - Louis Picard
- Department of Psychology, Sainte-Justine University Hospital Centre, Montreal, Canada
| | - Danielle Taddeo
- Division of Adolescent Medicine, Department of Pediatrics, Sainte-Justine University Hospital Centre, Université de Montréal, 3175 Chemin de la Côte-Ste-Catherine, Montreal, QC, H3T 1C5, Canada
| | | | - Debra K Katzman
- Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Linda Booij
- CHU Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Nicholas Chadi
- Division of Adolescent Medicine, Department of Pediatrics, Sainte-Justine University Hospital Centre, Université de Montréal, 3175 Chemin de la Côte-Ste-Catherine, Montreal, QC, H3T 1C5, Canada.
- CHU Sainte-Justine Hospital Research Centre, Montreal, Canada.
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Auger N, Steiger H, Luu TM, Chadi N, Low N, Bilodeau-Bertrand M, Healy-Profitós J, Ayoub A, Brousseau É, Israël M. Shifting age of child eating disorder hospitalizations during the Covid-19 pandemic. J Child Psychol Psychiatry 2023. [PMID: 37012056 DOI: 10.1111/jcpp.13800] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND We studied the effect of the Covid-19 pandemic on child eating disorder hospitalizations in Quebec, Canada. Quebec had one of the strictest lockdown measures targeting young people in North America. METHODS We analyzed eating disorder hospitalizations in children aged 10-19 years before and during the pandemic. We used interrupted time series regression to assess trends in the monthly number of hospitalizations for anorexia nervosa, bulimia nervosa, and other eating disorders before the pandemic (April 2006 to February 2020), and during the first (March to August 2020) and second waves (September 2020 to March 2021). We determined the types of eating disorders requiring hospital treatment and identified the age, sex and socioeconomic subgroups that were most affected. RESULTS Hospitalization rates for eating disorders increased during the first (6.5 per 10,000) and second waves (12.8 per 10,000) compared with the period before the pandemic (5.8 per 10,000). The increase occurred for anorexia nervosa as well as other types of eating disorders. The number of girls and boys aged 10-14 years admitted for eating disorders increased during wave 1. Wave 2 triggered an increase in eating disorder admissions among girls aged 15-19 years. Hospitalization rates increased earlier for advantaged than disadvantaged youth. CONCLUSIONS The Covid-19 pandemic affected hospitalizations for anorexia nervosa as well as other eating disorders, beginning with girls aged 10-14 years during wave 1, followed by girls aged 15-19 years during wave 2. Boys aged 10-14 years were also affected, as well as both advantaged and disadvantaged youth.
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Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Howard Steiger
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital, Montreal, QC, Canada
| | - Nicholas Chadi
- Department of Pediatrics, Sainte-Justine Hospital, Montreal, QC, Canada
| | - Nancy Low
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Marianne Bilodeau-Bertrand
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Jessica Healy-Profitós
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Aimina Ayoub
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Émilie Brousseau
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Mimi Israël
- Department of Psychiatry, McGill University, Montreal, QC, Canada
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Stapleton F, Abad JC, Barabino S, Burnett A, Iyer G, Lekhanont K, Li T, Liu Y, Navas A, Obinwanne CJ, Qureshi R, Roshandel D, Sahin A, Shih K, Tichenor A, Jones L. TFOS lifestyle: Impact of societal challenges on the ocular surface. Ocul Surf 2023; 28:165-199. [PMID: 37062429 PMCID: PMC10102706 DOI: 10.1016/j.jtos.2023.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Societal factors associated with ocular surface diseases were mapped using a framework to characterize the relationship between the individual, their health and environment. The impact of the COVID-19 pandemic and mitigating factors on ocular surface diseases were considered in a systematic review. Age and sex effects were generally well-characterized for inflammatory, infectious, autoimmune and trauma-related conditions. Sex and gender, through biological, socio-economic, and cultural factors impact the prevalence and severity of disease, access to, and use of, care. Genetic factors, race, smoking and co-morbidities are generally well characterized, with interdependencies with geographical, employment and socioeconomic factors. Living and working conditions include employment, education, water and sanitation, poverty and socioeconomic class. Employment type and hobbies are associated with eye trauma and burns. Regional, global socio-economic, cultural and environmental conditions, include remoteness, geography, seasonality, availability of and access to services. Violence associated with war, acid attacks and domestic violence are associated with traumatic injuries. The impacts of conflict, pandemic and climate are exacerbated by decreased food security, access to health services and workers. Digital technology can impact diseases through physical and mental health effects and access to health information and services. The COVID-19 pandemic and related mitigating strategies are mostly associated with an increased risk of developing new or worsening existing ocular surface diseases. Societal factors impact the type and severity of ocular surface diseases, although there is considerable interdependence between factors. The overlay of the digital environment, natural disasters, conflict and the pandemic have modified access to services in some regions.
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Affiliation(s)
- Fiona Stapleton
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia.
| | - Juan Carlos Abad
- Department of Ophthalmology, Antioquia Ophthalmology Clinic-Clofan, Medellin, Antioquia, Colombia
| | - Stefano Barabino
- ASST Fatebenefratelli-Sacco, Ospedale L. Sacco-University of Milan, Milan, Italy
| | - Anthea Burnett
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
| | - Geetha Iyer
- C. J. Shah Cornea Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Kaevalin Lekhanont
- Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tianjing Li
- Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Yang Liu
- Ophthalmology Department, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Alejandro Navas
- Conde de Valenciana, National Autonomous University of Mexico UNAM, Mexico City, Mexico
| | | | - Riaz Qureshi
- Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Danial Roshandel
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA, Australia
| | - Afsun Sahin
- Department of Ophthalmology, Koc University Medical School, İstanbul, Turkey
| | - Kendrick Shih
- Department of Ophthalmology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Anna Tichenor
- School of Optometry, Indiana University, Bloomington, IN, USA
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
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Monthuy-Blanc J, Corno G, Abou Chabake S. Exploring the impact of the COVID-19 pandemic on perceptual disturbances and dysfunctional eating attitudes and behaviors: A review of the literature. Front Psychol 2023; 14:1139261. [PMID: 37008865 PMCID: PMC10050699 DOI: 10.3389/fpsyg.2023.1139261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
From the outbreak of the novel coronavirus 2019 (COVID-19) a new physical and social distancing environment has changed our lives and, more particularly, the way of perceiving oneself, as well as eating attitudes and behaviors. An increasing number of studies have highlighted a risky scenario in terms of negative perceptions of one’s body as well as disordered eating and eating disorder patterns in both clinical and general population. With regard to this postulate, this literature review posits two main concepts—perceptual disturbances and dysfunctional eating attitudes and behaviors—in the general and (sub-)clinical populations, to provide an understanding of these phenomena during the COVID-19 pandemic. The main objective of this article is to provide a comprehensive and critical review of published scientific literature about perceptual disturbances (i.e., negative body image, body image disturbances, low body esteem) and dysfunctional eating attitudes and behaviors, including disordered eating (e.g., restrictive eating, binge-eating episodes, overeating, emotional eating) and eating disorders features in community (i.e., general population) and clinical and sub-clinical samples worldwide during the COVID-19 pandemic. The PubMed, ScienceDirect, Ebsco, and Google Scholar databases were searched. The initial search produced 42 references. Scientific publications from March 2020 to April 2022 were included, and among the works compiled, only published research articles have been retained. Purely theoretical papers were also excluded. The final selection consisted of 21 studies, covering both community, clinical (i.e., eating disorder population), and sub-clinical samples. The details of the results are discussed taking into consideration the potential impact of changes in the way we perceive ourselves and interact with others (e.g., the popularity of videoconferencing and the over-use of social network sites due to social isolation) as well as changes in eating attitudes and behaviors, physical activity and exercise (e.g., as an emotional response to the insecurity generated by the pandemic context), in community and (sub-)clinical samples. The discussion sheds light on two outcomes: (1) a summary of findings with methodological considerations; (2) an intervention continuum to deal with the consequences of the COVID-19 pandemic; (3) and a final conclusion.
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Affiliation(s)
- Johana Monthuy-Blanc
- Loricorps Research Unit, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Sciences of Education, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- *Correspondence: Johana Monthuy-Blanc,
| | - Giulia Corno
- Loricorps Research Unit, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Psychology and Psychoeducation, Laboratory of Cyberpsychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Sara Abou Chabake
- Loricorps Research Unit, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Psychology, LESPOIR Research Laboratory, Université de Montréal, Montréal, QC, Canada
- Department of Psychology, TRAJETS Research Laboratory, Université de Montréal, Montréal, QC, Canada
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McCabe M, Alcaraz-Ibanez M, Markey C, Sicilia A, Rodgers RF, Aimé A, Dion J, Pietrabissa G, Lo Coco G, Caltabiano M, Strodl E, Bégin C, Blackburn MÉ, Castelnuovo G, Granero-Gallegos A, Gullo S, Hayami-Chisuwa N, He Q, Maïano C, Manzoni GM, Mellor D, Probst M, Fuller-Tyszkiewicz M. A longitudinal evaluation of a biopsychosocial model predicting BMI and disordered eating among young adults. AUSTRALIAN PSYCHOLOGIST 2023. [DOI: 10.1080/00050067.2023.2181686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Affiliation(s)
- Marita McCabe
- School of Health Sciences, Swinburne University, Hawthorn, Australia
| | - Manuel Alcaraz-Ibanez
- Health Research Center and Department of Education, University of Almeria, Almeria, Spain
| | - Charlotte Markey
- Department of Psychology, Health Sciences Centre, Rutgers University, Camden, NJ, USA
| | - Alvaro Sicilia
- Health Research Center and Department of Education, University of Almeria, Almeria, Spain
| | - Rachel F. Rodgers
- Department of Applied Psychology, North Eastern University, Boston, MA, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
| | - Jacinthe Dion
- Department of Health Sciences, Université du Québec á Chicoutimi, Chicoutimi, Canada
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, S. Giuseppe Hospital, Oggebbio-Piancavallo, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Marie Caltabiano
- School of Psychology, James Cook University, Smithfield, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | | | | | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, S. Giuseppe Hospital, Oggebbio-Piancavallo, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | | | - Salvatore Gullo
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | | | - Qiqiang He
- School of Health Sciences, Wuhan University, Wuhan, PR China
| | - Christoph Maïano
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, S. Giuseppe Hospital, Oggebbio-Piancavallo, Italy
| | - David Mellor
- School of Psychology, Deakin University, Burwood, Australia
| | - Michel Probst
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Burwood, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Australia
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Güzel Â, Mutlu NL, Molendijk M. COVID-19-related changes in eating disorder pathology, emotional and binge eating and need for care: a systematic review with frequentist and Bayesian meta-analyses. Eat Weight Disord 2023; 28:19. [PMID: 36805344 PMCID: PMC9941242 DOI: 10.1007/s40519-023-01547-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
PURPOSE The COVID-19 pandemic has been a leading cause of stress and feelings of loss of control, both of which have been related to eating disorder (ED) pathology onset and deterioration. We aim to estimate the magnitude of changes in the prevalence rates of, and indicators for, ED psychopathology in the face of the COVID-19 pandemic. METHOD Pre-registered systematic review with frequentist and Bayesian meta-analyses. Searches for eligible studies were performed in PubMed, Web of Science and pre-print servers until January 15 2023. RESULTS Our searches yielded 46 eligible studies reporting on a total of 4,688,559 subjects. These data provide strong evidence indicating increased rates of diagnosed and self-reported ED's and a concordant increased need for care in the face of the pandemic. ED symptom severity scores in patients were not elevated during the pandemic, except for those related to anorexia nervosa. On average, people in the general population report relatively high levels of emotional and binge eating during the pandemic, although the evidential strength for these associations is only anecdotal to moderate. Moderators of between-study heterogeneity were not detected. CONCLUSIONS Altogether, our results suggest that the COVID-19 pandemic is associated with a wide spread negative effect on ED pathology in patient samples and the general population. The development of online prevention and intervention programs for EDs during stressful times like a pandemic is encouraged. A limitation is that the results reported here may be prone to biases, amongst others, self-report bias. LEVEL OF EVIDENCE Level I, systematic review and meta-analysis. PREREGISTRATION Prospero [ https://www.crd.york.ac.uk/prospero ] ID: CRD42022316105.
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Affiliation(s)
- Âmine Güzel
- Clinical Psychology Department, Leiden University, Leiden, The Netherlands
| | - Naz Lâl Mutlu
- Clinical Psychology Department, Leiden University, Leiden, The Netherlands
| | - Marc Molendijk
- Clinical Psychology Department, Leiden University, Leiden, The Netherlands.
- Leiden Institute of Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands.
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Di Tata D, Bianchi D, Pompili S, Laghi F. The Psychological Impact of the COVID-19 Pandemic on Alcohol Abuse and Drunkorexia Behaviors in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3466. [PMID: 36834161 PMCID: PMC9967230 DOI: 10.3390/ijerph20043466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 outbreak negatively affected young adults' psychological well-being, increasing their stress levels and symptoms of anxiety and depression, and potentially triggering health-risk behaviors. The present study was aimed at investigating the psychological impact of the COVID-19 pandemic on alcohol abuse and drunkorexia behaviors among young adults living in Italy. Participants were 370 emerging adults (63% women, 37% men; Mage = 21.00, SDage = 2.96, range: 18-30) who were recruited through an online survey between November 2021 and March 2022. Participants completed measures of alcohol abuse, drunkorexia behaviors, negative life experiences, and post-traumatic symptoms related to the COVID-19 outbreak. The results showed that the emotional impact and negative life experiences associated with the pandemic predicted both alcohol abuse and drunkorexia behaviors, albeit in different ways. Specifically, the number of negative life experiences during the pandemic and the tendency to avoid COVID-19-related negative thoughts positively predicted alcohol abuse; and the presence of intrusive thoughts associated with the pandemic significantly predicted the frequency of drunkorexia behaviors. Implications for research and clinical practice are discussed.
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Affiliation(s)
- Daniele Di Tata
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy
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Gao J, Zhou C, Liang H, Jiao R, Wheelock ÅM, Jiao K, Ma J, Zhang C, Guo Y, Luo S, Liang W, Xu L. Monkeypox outbreaks in the context of the COVID-19 pandemic: Network and clustering analyses of global risks and modified SEIR prediction of epidemic trends. Front Public Health 2023; 11:1052946. [PMID: 36761122 PMCID: PMC9902715 DOI: 10.3389/fpubh.2023.1052946] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 01/04/2023] [Indexed: 01/25/2023] Open
Abstract
Background Ninety-eight percent of documented cases of the zoonotic disease human monkeypox (MPX) were reported after 2001, with especially dramatic global spread in 2022. This longitudinal study aimed to assess spatiotemporal risk factors of MPX infection and predict global epidemiological trends. Method Twenty-one potential risk factors were evaluated by correlation-based network analysis and multivariate regression. Country-level risk was assessed using a modified Susceptible-Exposed-Infectious-Removed (SEIR) model and a risk-factor-driven k-means clustering analysis. Results Between historical cases and the 2022 outbreak, MPX infection risk factors changed from relatively simple [human immunodeficiency virus (HIV) infection and population density] to multiple [human mobility, population of men who have sex with men, coronavirus disease 2019 (COVID-19) infection, and socioeconomic factors], with human mobility in the context of COVID-19 being especially key. The 141 included countries classified into three risk clusters: 24 high-risk countries mainly in West Europe and Northern America, 70 medium-risk countries mainly in Latin America and Asia, and 47 low-risk countries mainly in Africa and South Asia. The modified SEIR model predicted declining transmission rates, with basic reproduction numbers ranging 1.61-7.84 in the early stage and 0.70-4.13 in the current stage. The estimated cumulative cases in Northern and Latin America may overtake the number in Europe in autumn 2022. Conclusions In the current outbreak, risk factors for MPX infection have changed and expanded. Forecasts of epidemiological trends from our modified SEIR models suggest that Northern America and Latin America are at greater risk of MPX infection in the future.
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Affiliation(s)
- Jing Gao
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,Respiratory Medicine Unit, Department of Medicine and Centre for Molecular Medicine, Karolinska Institute, Stockholm, Sweden,Heart and Lung Centre, Department of Pulmonary Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Cui Zhou
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Hanwei Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Rao Jiao
- Department of Mathematical Science, Tsinghua University, Beijing, China
| | - Åsa M. Wheelock
- Heart and Lung Centre, Department of Pulmonary Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kedi Jiao
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Jian Ma
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Chutian Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yongman Guo
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,Sitong Luo ✉
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,Wannian Liang ✉
| | - Lei Xu
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,*Correspondence: Lei Xu ✉
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Sanchez K, Hall LR, da Graca B, Bennett MM, Powers MB, Warren AM. The experience of COVID-19 among people with depression: Impact on daily life and coping strategies. J Affect Disord 2023; 321:59-65. [PMID: 36283536 PMCID: PMC9595490 DOI: 10.1016/j.jad.2022.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The prevalence of depression symptoms among U.S. adults increased dramatically during the early months of the COVID-19 pandemic. We sought to understand the impact of the pandemic on people with a history of depression. METHODS In June 2020, a national sample of 5023 U.S. adults, including 760 reporting past/current diagnoses of depression, completed survey measures related to the COVID experience, coping, anxiety, depression, and PTSD. RESULTS After adjusting for sociodemographic characteristics, a history of depression increased the odds of negative effects of pandemic on multiple aspects of life: routines, access to mental health treatment, alcohol use, prescription painkiller use, and other drug use. Those with a history of depression also scored significantly higher on the PHQ-8, GAD-7, and PDS-5 (all ps < 0.0001). Greater use of adaptive coping strategies was significantly associated with lower scores, and greater use of maladaptive strategies with higher scores. Individuals reporting a history of depression reported greater use of both adaptive and maladaptive strategies. CONCLUSIONS Adaptive coping strategies appear to be protective and help regulate symptomatology, suggesting that particular focus during the clinical encounter on developing tools to promote well-being, alleviate stress, and decrease perceptions of helplessness could mitigate the effects.
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Affiliation(s)
- Katherine Sanchez
- Baylor Scott & White Research Institute, Dallas, TX, United States of America; University of Texas at Arlington, School of Social Work, Arlington, TX, United States of America.
| | - Lauren R. Hall
- Baylor Scott & White Research Institute, Dallas, TX, United States of America
| | - Briget da Graca
- Baylor Scott & White Research Institute, Dallas, TX, United States of America
| | - Monica M. Bennett
- Baylor Scott & White Research Institute, Dallas, TX, United States of America
| | - Mark B. Powers
- Baylor Scott & White Research Institute, Dallas, TX, United States of America,Baylor University Medical Center, Dallas, TX, United States of America,Texas A&M University – College of Medicine, Dallas, TX, United States of America
| | - Ann Marie Warren
- Baylor Scott & White Research Institute, Dallas, TX, United States of America,Baylor University Medical Center, Dallas, TX, United States of America,Texas A&M University – College of Medicine, Dallas, TX, United States of America
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Jawed A, Lim M, Harrison A, Esposito G, Adusumilli N, Dimitriou D. Exploring the Impact of COVID-19 on Individuals with Eating Disorders in Saudi Arabia: A Thematic Analysis. Behav Sci (Basel) 2023; 13:bs13010069. [PMID: 36661641 PMCID: PMC9855056 DOI: 10.3390/bs13010069] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/14/2023] Open
Abstract
Food and sleep are critical for human survival. However, for individuals with eating disorders, they face two critical disruptions in terms of abnormal feeding patterns as well as poor sleep. These difficulties are exacerbated as a result of the recent coronavirus pandemic, which caused drastic changes in daily life schedules and living arrangements. The current study therefore aims to explore, through qualitative means, how individuals with eating disorders are affected during the subsequent lockdowns, with a particular emphasis on the pandemic's impact on their sleep in Saudi Arabia. Two groups of participants were recruited: participants with eating disorders and healthy controls. Based on thematic analysis of focus group discussion data, it was found that both types of participants experienced poorer sleep and poorer mental health. Participants with eating disorders too showed a deterioration of their symptoms. However, healthy participants tended to show greater levels of recovery and coping. Based on the study findings, recommendations for future studies are made.
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Affiliation(s)
- Aisha Jawed
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK
| | - Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, 48 Nanyang Avenue, Singapore 639818, Singapore
| | - Amy Harrison
- Department of Psychology and Human Development, University College London, 25 Woburn Square, London WC1H 0AA, UK
| | - Gianluca Esposito
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, 38122 Trento, Italy
| | - Nandini Adusumilli
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK
- Correspondence:
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Martini M, Longo P, Delsedime N, Abbate-Daga G, Panero M. Increased General, Eating, and Body-Related Psychopathology in Inpatients in a Specialized Eating Disorders Unit after the Beginning of the COVID-19 Pandemic: A Retrospective Comparison with the Pre-Pandemic Period. J Clin Med 2023; 12:jcm12020573. [PMID: 36675502 PMCID: PMC9866300 DOI: 10.3390/jcm12020573] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
The study of the effects of the COVID-19 pandemic on individuals who attended mental health services is needed to identify the specific vulnerabilities associated to this challenging period. Despite several analyses reporting the worsening of eating disorders symptomatology after the beginning of the pandemic, characterizations of adult inpatients with eating disorders are still lacking. We conducted a retrospective analysis to assess whether adult individuals who underwent hospitalization in a specialized eating disorders unit in the two years after the beginning of the COVID-19 pandemic differed in clinical presentation, psychopathological measures, and treatment outcomes from inpatients hospitalized in the two years before. In the comparison between the two groups, the individuals who began treatment after the start of the pandemic presented with more physical hyperactivity and more severe psychopathological scores in most of the areas investigated, with differences in eating symptoms still evident at discharge. Notably, body-related symptoms (i.e., body shape concerns, body checking, body avoidance) were associated with the pandemic, and also for inpatients with extreme anorexia nervosa. This retrospective analysis does not allow us to separate the impact of COVID-19 from other potentially relevant co-occurring factors; however, these findings help in understanding how the pandemic could have affected individuals that needed specialized intensive treatment.
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Romano KA, Lipson SK, Beccia AL, Quatromoni PA, Murgueitio J. Disparities in eating disorder symptoms and mental healthcare engagement prior to and following the onset of the COVID-19 pandemic: Findings from a national study of US college students. Int J Eat Disord 2023; 56:203-215. [PMID: 36479981 PMCID: PMC9851957 DOI: 10.1002/eat.23869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Early COVID-19 eating disorders (EDs) research used regionally restricted samples with little sociodemographic diversity. The present study aimed to address these research gaps by examining whether pandemic-related changes in ED symptoms and mental healthcare prevalence differed for historically marginalized groups within a national sample of US college students. METHOD Participants included 242,906 US college students (Mage = 23.45, SD = 7.04; MBMI = 25.28, SD = 5.91) who completed the repeated cross-sectional multi-institute Healthy Minds Study between January 2019 and May 2021. Moderated logistic regressions examined whether pandemic-related changes in individuals' likelihoods of exhibiting current probable ED, reporting lifetime ED diagnoses, and-among individuals with current probable ED-mental healthcare engagement differed for diverse gender, sexual, and racial/ethnic identity groups, and by body mass index (BMI) and financial stress. RESULTS There were increases of 5% and 12% in individuals' likelihoods of exhibiting current probable ED and symptomatic individuals' mental healthcare engagement, respectively, pre- to post-COVID-19 onset, but no pandemic-related changes in lifetime ED diagnosis prevalence. There were also important variations in these time-trends for different marginalized groups. For example, individuals identifying as genderqueer/gender nonconforming and lesbian exhibited increasing ED symptoms pre- to post-COVID-19 onset, and individuals with current probable ED and higher BMIs were increasingly likely to receive mental healthcare. Associations between financial stress, and the ED and mental healthcare outcomes did not change over time. DISCUSSION These findings provide insight into groups of US college students that experienced disproportionate ED burden during the pandemic at the population level, and directions for research and interventions that warrant consideration.
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Affiliation(s)
- Kelly A Romano
- Department of Psychology, Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Sarah K Lipson
- Boston University School of Public Health, Department of Health Law Policy and Management, Boston, Massachusetts, USA
| | - Ariel L Beccia
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Paula A Quatromoni
- Department of Health Sciences, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, USA
| | - Jose Murgueitio
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Tsiandoulas K, McSheffrey G, Fleming L, Rawal V, Fadel MP, Katzman DK, McCradden MD. Ethical tensions in the treatment of youth with severe anorexia nervosa. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:69-76. [PMID: 36206789 DOI: 10.1016/s2352-4642(22)00236-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 12/23/2022]
Abstract
Treatment of anorexia nervosa poses a moral quandary for clinicians, particularly in paediatrics. The challenges of appropriately individualising treatment while balancing prospective benefits against concomitant harms are best highlighted through exploration and discussion of the ethical issues. The purpose of this Viewpoint is to explore the ethical tensions in treating young patients (around ages 10-18 years) with severe anorexia nervosa who are not capable of making treatment-based decisions and describe how harm reduction can reasonably be applied. We propose the term AN-PLUS to refer to the subset of patients with a particularly concerning clinical presentation-poor quality of life, lack of treatment response, medically severe and unstable, and severe symptomatology-who might benefit from a harm reduction approach. From ethics literature, qualitative studies, and our clinical experience, we identify three core ethical themes in making treatment decisions for young people with AN-PLUS: capacity and autonomy, best interests, and person-centred care. Finally, we consider how a harm reduction approach can provide direction for developing a personalised treatment plan that retains a focus on best interests while attempting to mitigate the harms of involuntary treatment. We conclude with recommendations to operationalise a harm reduction approach in young people with AN-PLUS.
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Affiliation(s)
- Kate Tsiandoulas
- Department of Bioethics, The Hospital for Sick Children, Toronto, ON, Canada; Health Science Research Program, University of Toronto, Toronto, ON, Canada
| | - Gordon McSheffrey
- Department of Pediatrics, Scarborough Health Network, Toronto, ON, Canada; Child, Youth, Family Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Lindsay Fleming
- Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Vandana Rawal
- Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Marc P Fadel
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Division of Child and Youth Mental Health, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Debra K Katzman
- Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, ON, Canada; The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Melissa D McCradden
- Department of Bioethics, The Hospital for Sick Children, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Genetics & Genome Biology, Peter Gilgan Centre for Research & Learning, Toronto, ON, Canada.
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Steinberg D, Perry T, Freestone D, Bohon C, Baker JH, Parks E. Effectiveness of delivering evidence-based eating disorder treatment via telemedicine for children, adolescents, and youth. Eat Disord 2023; 31:85-101. [PMID: 35695470 DOI: 10.1080/10640266.2022.2076334] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Barriers limit access to eating disorder treatment. Evidence-based treatment delivered using telemedicine could expand access. This study determined the effectiveness of enhanced Family-Based Treatment (FBT+) delivered using telemedicine for children and adolescents with eating disorders. Participants had a confirmed eating disorder diagnosis, lived in states where treatment was available, and lived with a family member willing to participate. Virtual FBT+ was administered by a five-person team including a therapist, dietitian, medical provider, peer mentor, and family mentor for up to 12 months. Measures were recorded at baseline and varying frequencies throughout treatment. Weight was self-reported. Eating disorder symptoms were assessed with the Eating Disorder Examination-Questionnaire Short Form (EDE-QS) and depression and anxiety were measured using the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7). Caregiver burden and self-efficacy were measured using the Burden Assessment Scale, and Parent Versus Eating Disorder scale. The majority of patients (N = 210; 6 to 24 years old [mean 16 · 1 years]) were cisgender female (83%) White, (71%), required weight restoration (78%), and had anorexia nervosa, restricting type (63%). After 16 weeks, patients on weight restoration gained on average 11 · 3 [9 · 86, 12 · 8] pounds and the average change in EDE-QS score was -6 · 31 [-8 · 67, -4 · 10] points. Similar reductions were seen for depression (-2 · 62 [-4 · 24, -1 · 04]), anxiety (-1 · 44 [-1 · 12, 0 · 78]), and caregiver burden (-4 · 41 [2 · 45, 6 · 31]). Caregiver self-efficacy increased by 4 · 56 [3 · 53, 5 · 61] points. Patients and caregivers reported satisfaction with treatment. Virtual FBT+ for eating disorders can transcend geographical and psychosocial treatment barriers, expanding access to evidence-based eating disorder treatment.
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Affiliation(s)
- Dori Steinberg
- Clinical Department, Equip Health, Carlsbad, California, USA.,Duke University School of Nursing, Durham, North Carolina, USA
| | - Taylor Perry
- Clinical Department, Equip Health, Carlsbad, California, USA
| | - David Freestone
- Clinical Department, Equip Health, Carlsbad, California, USA
| | - Cara Bohon
- Clinical Department, Equip Health, Carlsbad, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Jessica H Baker
- Clinical Department, Equip Health, Carlsbad, California, USA
| | - Erin Parks
- Clinical Department, Equip Health, Carlsbad, California, USA
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Termorshuizen JD, Sun Q, Borg S, Mantilla EF, Goode RW, Peat CM, Thornton LM, Watson H, van Furth EF, Birgegård A, Bulik CM. Longer-term impact of COVID-19 among individuals with self-reported eating disorders in the United States, the Netherlands, and Sweden. Int J Eat Disord 2023; 56:80-90. [PMID: 36237128 PMCID: PMC9851943 DOI: 10.1002/eat.23824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE We assessed eating disorder (ED) illness status, symptomatology, treatment access, anxiety, and depression in the first year of the COVID-19 pandemic among individuals with a pre-existing ED in the United States (US), the Netherlands (NL), and Sweden (SE). METHODS Participants completed online surveys in April-July 2020, at the early stage of the pandemic, and one year later. At one-year follow-up, we added questions addressing retrospective changes in ED symptoms, treatment, and anxiety/depression since the start of the COVID-19 pandemic. We present descriptive statistics and assess change in ED symptomatology, treatment, and anxiety/depression among those with an active or lingering ED. RESULTS Participants (US n = 132; NL n = 219; SE n = 702) were mostly young and female with a history of anorexia nervosa (>60% in all three countries). Across countries, respondents reported impact of COVID-19 on ED symptoms at both time points, with improvement in US and NL at one-year follow-up, and stable but less impact on ED symptoms in SE. Furthermore, at one-year follow-up, roughly half of those in treatment reported reduced treatment access and quality, and the majority of the sample reported increased anxiety and depressive mood since the start of the pandemic. DISCUSSION Our findings suggest that the self-perceived impact of COVID-19 changed over time but remained concerning even one year after the start of the pandemic. Clinicians, community organizations, and policy makers are encouraged to address potentially changing treatment needs in the face of public health emergency events. PUBLIC SIGNIFICANCE Our findings suggest that the impact of COVID-19 on individuals with eating disorders decreased over time but remained concerning even one year after the start of the pandemic and that the impact differed across countries. Clinicians, community organizations, and policy makers are encouraged to incorporate this knowledge to address potentially changing treatment needs in the face of public health emergency events.
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Affiliation(s)
- Jet D. Termorshuizen
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- GGZ Rivierduinen Eating Disorders UrsulaLeidenSouth HollandThe Netherlands
| | - Quan Sun
- Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Stina Borg
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Emma F. Mantilla
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Rachel W. Goode
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Christine M. Peat
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hunna Watson
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Discipline of Psychology, School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
- Division of Paediatrics, School of MedicineThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - Eric F. van Furth
- GGZ Rivierduinen Eating Disorders UrsulaLeidenSouth HollandThe Netherlands
- Department of PsychiatryLeiden University Medical CenterLeidenSouth HollandThe Netherlands
| | - Andreas Birgegård
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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43
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Milliren CE, Richmond TK, Hudgins JD. Emergency Department Visits and Hospitalizations for Eating Disorders During the COVID-19 Pandemic. Pediatrics 2023; 151:190339. [PMID: 36541052 DOI: 10.1542/peds.2022-058198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Recent studies have reported increasing eating disorder incidence and severity following the coronavirus disease 2019 (COVID-19) pandemic. In a diverse cohort of pediatric hospitals, we examined trends in the volume of emergency visits and inpatient admissions for eating disorders before and during the pandemic. METHODS We examined monthly trends in volume of patients with eating disorders (identified by principal International Classification of Diseases, 10th Revision, diagnosis codes) across 38 hospitals in the Pediatric Health Information System pre- (January 2018-March 2020) and post-COVID-19 onset (April 2020-June 2022). Using interrupted time series analysis, we examined the pre- and post monthly trends in eating disorder emergency and inpatient volume. RESULTS Before the pandemic, eating disorder emergency visit volume was increasing by 1.50 visits per month (P = .006), whereas in the first year postonset, visits increased by 12.9 per month (P < .001), followed by a 6.3 per month decrease in the second year postonset (P < .001). Pre-COVID-19, eating disorder inpatient volume was increasing by 1.70 admissions per month (P = .01). In the first year postonset, inpatient volume increased by 11.9 per month (P < .001), followed by a 7.6 per month decrease in the second year postonset (P < .001). CONCLUSIONS The volume of patients seeking emergency and inpatient eating disorder care at pediatric hospitals has increased dramatically since the pandemic onset and has not returned to prepandemic levels despite a decline in the second year postonset, with important implications for hospital capacity.
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Affiliation(s)
| | - Tracy K Richmond
- Divisions of Adolescent and Young Adult Medicine.,Departments of Pediatrics
| | - Joel D Hudgins
- Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.,Emergency Medicine, Harvard Medical School, Boston, Massachusetts
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Goode RW, Godoy SM, Wolfe H, Olson K, Agbozo B, Mueller A, Noem T, Malian H, Peat CM, Watson H, Thornton LM, Gwira R, Bulik CM. Perceptions and experiences with eating disorder treatment in the first year of COVID-19: A longitudinal qualitative analysis. Int J Eat Disord 2023; 56:247-256. [PMID: 36574733 PMCID: PMC9880652 DOI: 10.1002/eat.23888] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The COVID-19 pandemic created significant challenges in accessing and receiving treatment for individuals with eating disorders (EDs). The purpose of this study is to explore perceptions of and experiences with ED treatment during the first year of the pandemic among individuals with past and self-reported EDs in the United States. METHODS Online surveys were administered to adults (N = 510) with a past or current self-reported ED at 13 timepoints between April 2020 and May 2021. Using longitudinal qualitative analysis, 5651 free-text responses were examined to capture experiences with ED treatment and generate inferences of change over time. RESULTS We categorized results into four sequential, temporal quarters and identified patterns that explained participants' perceptions of facilitators, barriers, and experiences with ED treatment over time: Quarter 1. Treatment Disruption and Reorienting Recovery; Quarter 2. Accumulating COVID-19 Stress and Virtual Treatment Woes; Quarter 3. A Continuation of Inadequate Care; and Quarter 4. Ongoing Adaptation and Adjustment to Uncertainty. Participant experiences were marked by numerous barriers to accessing care, challenges adjusting to virtual treatment, unmet treatment needs, and beginning acceptance of telehealth. DISCUSSION Our findings present a timeline to help evaluate challenges related to navigating the switch to virtual care which created significant disruption to ED recovery. Participants spent much of the first year trying to adjust to unemployment, loss of insurance, and lack of access to in-person treatment. Future research should identify additional strategies to improve the receipt and experience of care for EDs. PUBLIC SIGNIFICANCE Our findings suggest that individuals with eating disorders were significantly challenged by accumulating COVID-19 stress, worsening symptomatology, and limited access to effective treatment during the first year of the pandemic. This knowledge can guide clinicians, treatment centers, and policy makers in addressing the behavioral health needs of individuals impacted by disordered eating amidst emergent public health crises.
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Affiliation(s)
- Rachel W. Goode
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Sarah M. Godoy
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hannah Wolfe
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Katie Olson
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Bridgette Agbozo
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Abigail Mueller
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Taylor Noem
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hannah Malian
- Department of Nutrition, Gillings School of Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Christine M. Peat
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hunna Watson
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Discipline of Psychology, School of Population HealthCurtin UniversityPerthAustralia,Division of Paediatrics, School of MedicineThe University of Western AustraliaPerthAustralia
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Rebecca Gwira
- Department of Counseling and Psychological ServicesGeorgia State UniversityAtlantaGeorgiaUSA
| | - Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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Mitchell KS, Smith BN, Masheb R, Vogt D. The impact of the COVID-19 pandemic on eating disorders in U.S. military veterans. Int J Eat Disord 2023; 56:108-117. [PMID: 36239518 DOI: 10.1002/eat.23822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE The COVID-19 pandemic has had a profound impact on mental health around the world. Although there have been reports that the incidence of eating disorders (EDs) has increased during the pandemic, few longitudinal studies have examined recent changes in EDs. Men and women with military histories may be particularly vulnerable to EDs, underscoring the importance of investigating the impact of the COVID-19 pandemic on EDs in this population. METHOD We examined whether early-pandemic (Time 1; T1) posttraumatic stress disorder, depression, anxiety, and stress symptoms were associated with change in probable ED diagnostic status 1 year later (T2). We also investigated relationships from early pandemic mental health symptoms to change in ED diagnostic status from T1 to T2 via pandemic-related life circumstance pathways (health, financial, social, etc.). Participants included a population-based sample of 372 U.S. veterans who completed the T1 and T2 surveys. RESULTS Early pandemic mental health was significantly and positively associated with probable ED diagnostic status. Social and health satisfaction as well as physical health pandemic impacts mediated the associations between mental health symptoms and ED diagnostic status. DISCUSSION Findings highlight the importance of bolstering social connection, health-promoting behaviors, and access to ED treatment among veteran men and women impacted by the COVID-19 pandemic. PUBLIC SIGNIFICANCE The COVID-19 pandemic has had a profound impact on mental health, including eating disorders (EDs). We found that early pandemic mental health symptoms were significantly associated with changes in U.S. veterans' ED diagnostic status 1 year later. Mental health symptoms increased ED diagnoses via their impact on social and health satisfaction, as well as physical health impacts of the pandemic. Findings highlight the importance of increasing social connection, health-promoting behaviors, and ED treatment access among veteran men and women, who may be particularly vulnerable to EDs, during the COVID pandemic.
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Affiliation(s)
- Karen S Mitchell
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, United States.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Brian N Smith
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, United States.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Robin Masheb
- VA Connecticut Healthcare System, West Haven, Connecticut, United States.,Department of Psychiatry, Yale School of Medicine, West Haven, Connecticut, United States
| | - Dawne Vogt
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, United States.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, United States
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46
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Thompson KA, Hedlund EL, Sun Q, Peat CM, Goode RW, Termorshuizen JD, Thornton LM, Borg S, van Furth EF, Birgegård A, Bulik CM, Watson HJ. Course and predictors of eating disorder symptoms, anxiety symptoms, and pandemic-related eating disorder concerns among adults with eating disorders during the first year of the COVID-19 pandemic. Int J Eat Disord 2023; 56:151-168. [PMID: 36508290 PMCID: PMC9877876 DOI: 10.1002/eat.23870] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/29/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The COVID-19 pandemic and public health mitigation measures have negatively impacted individuals with eating disorders (ED). We evaluated changes in and predictors of ED symptoms, pandemic-related ED concerns, and anxiety symptoms across the first 12 months of the COVID-19 pandemic among individuals with self-reported EDs in the United States (US), Sweden (SE), and the Netherlands (NL). METHOD Participants in the US (N = 510), SE (N = 982), and NL (N = 510) completed an online survey assessing ED symptoms (binge eating, restriction, compensatory behaviors, and anxiety about being unable to exercise), general anxiety symptoms, and pandemic-related ED concerns about accessing food, lack of structure and social support, being in a triggering environment, and food and treatment costs. In the US and NL, respondents completed surveys beginning April 2020 and continuing monthly for a year. In SE, respondents completed baseline surveys in May 2020, a six-month follow-up around December 2020, and a 12-month follow-up in May 2021. RESULTS Three patterns emerged: (1) a curvilinear course with the highest level of symptoms at baseline, declining through November 2020, and increasing through the rest of the year; (2) a linear declining course over time; and (3) a stable course with no changes. Worries about COVID-19 infection, lockdown, concerns about lack of structure and social support, and concerns about accessing food consistent with one's recovery meal plan predicted increases in ED symptoms. DISCUSSION ED symptoms tracked with pandemic-related concerns in people with EDs. Conceptualizing predictors of symptoms may inform therapy and public health resources that reduce the impact of pandemics on mental health. PUBLIC SIGNIFICANCE Our findings suggest that the COVID-19 pandemic had negative impacts on people with eating disorders, including amplification of mental health symptoms and stressors around peak periods of infection and COVID-19 restrictions. These findings inform medical providers, policy-makers, and community-based supports about the information and resource needs of this group to ensure efficient dissemination in future public health emergencies and during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Katherine A. Thompson
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Elin L. Hedlund
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Quan Sun
- Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Christine M. Peat
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Rachel W. Goode
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Jet D. Termorshuizen
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Rivierduinen Eating Disorders UrsulaLeidenthe Netherlands
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Stina Borg
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Eric F. van Furth
- Rivierduinen Eating Disorders UrsulaLeidenthe Netherlands,Department of PsychiatryLeiden University Medical CenterLeidenthe Netherlands
| | - Andreas Birgegård
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hunna J. Watson
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Discipline of Psychology, School of Population HealthCurtin UniversityPerthAustralia,Division of Paediatrics, School of MedicineThe University of Western AustraliaPerthAustralia
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47
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Yao Y, Liu ZJ, Zhang YK, Sun HJ. Mechanism and potential treatments for gastrointestinal dysfunction in patients with COVID-19. World J Gastroenterol 2022; 28:6811-6826. [PMID: 36632313 PMCID: PMC9827583 DOI: 10.3748/wjg.v28.i48.6811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/01/2022] [Accepted: 12/07/2022] [Indexed: 12/26/2022] Open
Abstract
The global coronavirus disease 2019 (COVID-19) has become one of the biggest threats to the world since 2019. The respiratory and gastrointestinal tracts are the main targets for severe acute respiratory syndrome coronavirus 2 infection for they highly express angiotensin-converting enzyme-2 and transmembrane protease serine 2. In patients suffering from COVID-19, gastrointestinal symptoms have ranged from 12% to 61%. Anorexia, nausea and/or vomiting, diarrhea, and abdominal pain are considered to be the main gastrointestinal symptoms of COVID-19. It has been reported that the direct damage of intestinal mucosal epithelial cells, malnutrition, and intestinal flora disorders are involved in COVID-19. However, the underlying mechanisms remain unclear. Thus, in this study, we reviewed and discussed the correlated mechanisms that cause gastrointestinal symptoms in order to help to develop the treatment strategy and build an appropriate guideline for medical workers.
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Affiliation(s)
- Yang Yao
- Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, College of Basic Medical, Chongqing 404120, China
- Department of Clinical Pharmacology, College of Pharmacy, Dalian 116044, Liaoning Province, China
- Ministry of Public Infrastructure, Chongqing Three Gorges Medical College, Chongqing 404120, China
| | - Zhu-Jun Liu
- Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, College of Basic Medical, Chongqing 404120, China
- Department of Basic Medicine, Chongqing Three Gorges Medical College, Chongqing 404120, China
- Department of Business Administration, Metropolitan College of Science and Technology, Chongqing 404120, China
| | - Yu-Kun Zhang
- Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, College of Basic Medical, Chongqing 404120, China
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, Peking University, Beijing 100191, China
| | - Hui-Jun Sun
- Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, College of Basic Medical, Chongqing 404120, China
- Department of Clinical Pharmacology, College of Pharmacy, Dalian Medical University, Dalian 116044, Liaoning Province, China
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48
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Santoso M, Milliren CE, Woods ER, Forman SF, Richmond TK. COVID-19 related familial economic disruptions and eating disorder patients' mental health concerns and motivation to recover. J Eat Disord 2022; 10:197. [PMID: 36539850 PMCID: PMC9764300 DOI: 10.1186/s40337-022-00709-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Family support has been shown to be important for adolescents and young adults (AYA) in eating disorder (ED) treatment. Many families were impacted by the pandemic, potentially altering their ability to support individuals in ED treatment. This study examined the association of COVID-19 related familial economic change with self-reported mental health (MH) and ED concerns in AYA seeking treatment for ED. METHODS AYA patients with EDs aged 10-27 years enrolled in the Registry of Eating Disorders and their Co-morbidities OVER time in Youth (RECOVERY) completed an additional COVID-19-specific survey (n = 89) that assessed their perception of the effects of the pandemic on their lives and their ED. Participants self-reported on familial economic disruptions, measured through a composite score of four markers: (1) family member's work hours cut, (2) family member was required to stop working, (3) family member lost job permanently, and (4) family lost health insurance/benefits. In bivariate analyses, we examined the association between self-reporting any familial economic disruption and self-reported changes in intrusive ED thoughts, feelings of anxiety, feelings of depression, feelings of isolation, and motivation to recover from their ED. Logistic regression models were used to examine the association between familial economic disruptions on self-reported changes in ED/MH affect and motivation to recover adjusting for age and ED diagnosis. RESULTS Forty-six percent of participants self-reported that the pandemic had resulted in at least one economic familial disruption. Of patients reporting any familial economic disruption, 29% reported decreased motivation for ED recovery, and over 75% reported worsening feelings of depression, anxiety, isolation, and/or intrusive eating disorder thoughts. Reporting any COVID-19 familial economic disruption was marginally associated with feelings of isolation (p = 0.05). Though the findings were only marginally significant, the odds of reporting worsening feelings of depression, anxiety, intrusive ED thoughts or motivation to recover were nearly twice in those who reported a COVID-19-related familial economic disruption compared to those who did not report such a disruption. CONCLUSIONS Family-related economic disruptions are associated with ED/MH-related concerns and motivation to recover from an ED during the COVID-19 pandemic in AYA patients.
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Affiliation(s)
- Monique Santoso
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, USA.
| | - Carly E Milliren
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, USA.,Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, USA
| | - Elizabeth R Woods
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, USA.,Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Sara F Forman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, USA.,Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, USA.,Department of Pediatrics, Harvard Medical School, Boston, USA
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49
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Hoover LV, Ackerman JM, Cummings JR, Gearhardt AN. The Association of Perceived Vulnerability to Disease with Cognitive Restraint and Compensatory Behaviors. Nutrients 2022; 15:nu15010008. [PMID: 36615665 PMCID: PMC9824184 DOI: 10.3390/nu15010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Individual differences exist in perceived vulnerability to disease (PVD). PVD is associated with negative responses (e.g., disgust) towards individuals with obesity and heightened sensitivity regarding personal appearance. Through increasing fear of fat (FOF), PVD may be associated with cognitive restraint and compensatory behaviors. We utilized an adult sample (n = 247; 53.3% male sex assigned at birth) recruited through Amazon's MTurk prior to the COVID-19 pandemic to investigate associations between PVD, cognitive restraint and compensatory behaviors. Participants completed the Perceived Vulnerability to Disease Scale, Eating Disorder Diagnostic Scale, Dutch Eating Behaviors Questionnaire, and Goldfarb's Fear of Fat Scale. Mediation analyses were used to test our hypotheses. Perceived infectability (PVD-Infection) was associated with cognitive restraint and compensatory behaviors through increased FOF. Perceived germ aversion (PVD-Germ) was associated with cognitive restraint, but FOF did not mediate this association. Sex-stratified analyses revealed no significant sex differences. PVD may be an overlooked factor associated with cognitive restraint and compensatory behaviors in males and females. FOF was an important mediating factor in these associations. Increased engagement in cognitive restraint and compensatory behaviors may reflect attempts to reduce FOF. Future longitudinal research should explore whether PVD is a risk factor for cognitive restraint and compensatory behaviors.
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50
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Monthuy-Blanc J, Corno G, Bouchard S, St-Pierre MJ, Bourbeau F, Mostefa-Kara L, Therrien É, Rousseau M. Body perceptions, occupations, eating attitudes, and behaviors emerged during the pandemic: An exploratory cluster analysis of eaters profiles. Front Psychol 2022; 13:949373. [PMID: 36544438 PMCID: PMC9762356 DOI: 10.3389/fpsyg.2022.949373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction COVID-19 pandemic negatively impacted people's mental and physical health. Three areas have been significantly impacted, among others: eating-related behaviors, occupational balance, and exposure to self-image due to videoconferencing. This study aims to explore and document eaters profiles that were reported during the pandemic in the general Canadian population using a holistic perspective, including body perceptions, attitudes, and eating behaviors (i.e., body image, behaviors, attitudes, and motivations regarding food), and occupations (i.e., physical activity and cooking). Methods This cross-sectional study was conducted from May to September 2020. Two hundred and seventy-three Canada's residents, French speaking of 18 years of age and older, participated in an online survey on behaviors, attitudes, and motivations regarding food and eating as well as body image and occupations during the COVID-19 pandemic. A hierarchical cluster analysis was used to determine the eaters profiles. One-way ANOVA and Chi-square test were conducted to differentiate occupational characteristics between eaters profiles. Results Three distinctive profiles were found during the COVID-19 pandemic and could be placed on a continuum: the Congruent-driven eater is at the functional pole of the continuum, whereas the Incongruent-driven eater is at the dysfunctional pole of the eaters continuum. In the middle of the continuum, the Incongruent-perceptual eater is at a critical crossing point. Significant differences were reported between eaters profiles. Discussion The empirical results based on an eaters continuum conceptualization highlight the importance of understanding how people perceive their body to assess and promote food well-being.
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Affiliation(s)
- Johana Monthuy-Blanc
- Groupe de Recherche Loricorps, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Center of Mental Health University Institute of Montreal, Montreal (CR-IUSMM), Montréal, QC, Canada
| | - Giulia Corno
- Groupe de Recherche Loricorps, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Chaire de Recherche du Canada en Cyberpsychologie Clinique, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Stéphane Bouchard
- Groupe de Recherche Loricorps, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Chaire de Recherche du Canada en Cyberpsychologie Clinique, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Marie-Josée St-Pierre
- Groupe de Recherche Loricorps, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Center of Mental Health University Institute of Montreal, Montreal (CR-IUSMM), Montréal, QC, Canada
| | - Francisca Bourbeau
- Groupe de Recherche Loricorps, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Center of Mental Health University Institute of Montreal, Montreal (CR-IUSMM), Montréal, QC, Canada
| | - Leïla Mostefa-Kara
- Groupe de Recherche Loricorps, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Center of Mental Health University Institute of Montreal, Montreal (CR-IUSMM), Montréal, QC, Canada
| | - Émie Therrien
- Groupe de Recherche Loricorps, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Center of Mental Health University Institute of Montreal, Montreal (CR-IUSMM), Montréal, QC, Canada
| | - Michel Rousseau
- Groupe de Recherche Loricorps, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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