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López-Villatoro JM, Díaz-Marsá M, Gálvez-Merlin A, De la Higuera-González P, Carrasco JL. Mentalizing deficits in borderline personality disorder related to axis I comorbidity: Clinical relevance. Early Interv Psychiatry 2024. [PMID: 39009509 DOI: 10.1111/eip.13593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 06/07/2024] [Accepted: 06/30/2024] [Indexed: 07/17/2024]
Abstract
AIM Deficits in mentalization have been described in several mental disorders, but information is still scarce and ambiguous about the types of mentalization errors in each disorder and their specificity and severity in borderline personality disorder (BPD). Due to the high comorbidity between this disorder and axis I disorders, the aim of this work is to study differences in mentalization responses in BPD considering the different comorbidity profiles with other disorders. METHODS A total of 141 BPD patients were evaluated using The Mini-International Neuropsychiatric Interview (MINI), to identify comorbid axis I disorders. Mentalizing ability was assessed by the Movie for the Assessment of Social Cognition (MASC). Statistical associations were analysed into the different variables. RESULTS Patients with comorbid BPD and anorexia nervosa (AN), suicidal behaviour disorder or post-traumatic stress disorder (PTSD) respectively presented higher overmentalization, undermentalization and absence of mentalization errors, compared with patients with BPD without comorbidity. CONCLUSIONS Results show that BPD comorbidity with AN, suicidal behaviour disorder and PTSD affect to the types and severity of mentalizing deficits observed in these patients. This study highlights the importance of the assessment and treatment of axis I comorbid disorders in borderline personality disorder, with the objective of shaping personalized treatment for every patient.
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Affiliation(s)
- José Manuel López-Villatoro
- Health Research Institute, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - M Díaz-Marsá
- Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Madrid, Spain
| | - A Gálvez-Merlin
- Health Research Institute, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - P De la Higuera-González
- Health Research Institute, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Personality, Assessment and Clinical Psychology, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - J L Carrasco
- Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Madrid, Spain
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Bazo Perez M, Frazier LD. Risk and resilience in eating disorders: differentiating pathways among psychosocial predictors. J Eat Disord 2024; 12:62. [PMID: 38773646 PMCID: PMC11110273 DOI: 10.1186/s40337-024-01023-x] [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: 10/20/2023] [Accepted: 05/15/2024] [Indexed: 05/24/2024] Open
Abstract
OBJECTIVE Eating disorders (EDs) represent a rising global health concern. The current study takes a multivariate approach to examine psychological (i.e., perfectionism, anxiety sensitivity [AS], emotion dysregulation) and sociocultural factors (i.e., body dissatisfaction) that may relate to risk and resilience in EDs. METHODS Participants were 698 undergraduate students (Mage = 21, SDage = 4.02), mainly female (71%) and Hispanic (61.6%), who participated in an online survey assessing perfectionism, emotion dysregulation, AS, body dissatisfaction, and eating behaviors. RESULTS The results from structural equation model analyses revealed differential associations with disordered eating (DE) outcomes. Self-oriented perfectionism and dysmorphic appearance concerns were associated with increased dieting/carb restriction, desire for thinness, and binging tendencies. Specifically, emotional nonacceptance and lack of emotional awareness showed associations with elevated risk for dieting/carb restriction and purging tendencies, respectively. Conversely, lack of emotional clarity showed a protective pathway to these risk behaviors. Anxiety sensitivity cognitive concerns related to higher purging tendencies, while AS social concerns related to lower purging and binging tendencies. DISCUSSION Findings highlight the differential pathways of psychosocial risk and resilience for EDs. Subscales of emotional dysregulation and AS showed risk as well as resilience associations with DE outcomes. This information is key for advancing transdiagnostic prevention and intervention to reduce the rising rates of EDs.
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Affiliation(s)
- Maria Bazo Perez
- Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Leslie D Frazier
- Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
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Asgarizadeh A, Mazidi M, Preece DA, Dehghani M. Construct Validity and Measurement Invariance of the Difficulties in Emotion Regulation Scale - Short Form (DERS-SF): Further Evidence From Community and Student Samples. J Pers Assess 2024:1-11. [PMID: 38647207 DOI: 10.1080/00223891.2024.2340506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 02/21/2024] [Indexed: 04/25/2024]
Abstract
The current study aimed to evaluate the psychometric properties of the Difficulties in Emotion Regulation Scale-Short Form (DERS-SF) in Iran, including testing its measurement invariance across sexes, as well as community and student populations. Two samples were recruited: a community sample of 583 participants (58.7% female; Mage = 33.55) and a university student sample of 409 participants (67.2% female; Mage = 24.48). Besides the DERS-SF, participants completed a battery of instruments online, measuring mentalizing capacity and borderline personality features. Confirmatory factor analyses supported the tenability of the five-factor model, excluding the awareness subscale. Except for the awareness subscale, acceptable to excellent internal consistencies were found for the DERS-SF and its subscales. The awareness-excluded DERS-SF was significantly and strongly associated with relevant constructs (|rs| = .49 to .59). This study also found evidence for configural, metric, and scalar invariance of the DERS-SF across sexes and community and student populations. Our findings extended the evidence for the validity and reliability of the DERS-SF and its awareness-excluded version by administering it in Iranian samples and supporting its cross-cultural applicability.
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Affiliation(s)
- Ahmad Asgarizadeh
- Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran
| | - Mahdi Mazidi
- Centre for the Advancement of Research on Emotion, The University of Western Australia, Crawley, WA, Australia
| | - David A Preece
- School of Psychological Science, The University of Western Australia, Perth, Australia
- School of Psychology, Curtin University, Perth, Australia
| | - Mohsen Dehghani
- Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran
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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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López-Villatoro JM, De la Torre-Luque A, MacDowell KS, Galvez-Merlin A, Gómez Del Barrio A, Beato-Fernández L, Ruiz-Guerrero F, Mola-Cardenes P, Polo-Montes F, León-Velasco M, Castro-Fuentes L, Leza JC, Carrasco JL, Díaz-Marsá M. Transdiagnostic inflammatory and oxidative biomarkers with predictive capacity of self-injurious behavior in impulsive and unstable disorders. Prog Neuropsychopharmacol Biol Psychiatry 2024; 130:110927. [PMID: 38151169 DOI: 10.1016/j.pnpbp.2023.110927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/17/2023] [Accepted: 12/22/2023] [Indexed: 12/29/2023]
Abstract
INTRODUCTION Alterations in inflammatory processes have previously been reported in impulsive and unstable disorders, as well as in other psychiatric conditions. In order to investigate transdiagnostic biomarkers associated with various phenotypic features of these disorders, this study is designed to identify biomarkers of inflammatory and oxidative endophenotypes related to autolytic behavior. METHODS Peripheral blood mononuclear cells were collected from 35 patients with borderline personality disorder (BPD), 29 patients with restrictive eating disorder (rED), 21 patients with purging eating disorder (pED) and 23 control subjects. Plasma levels of different inflammatory and oxidative factors were measured by ELISA and the expression of selected proteins was by Western Blot. Principal component analysis (PCA) was performed to categorize the different inflammatory factors. Additionally, Ancova was performed to observe the differences in the principal components among the different groups and logistic regression analysis was conducted to assess the predictive capacity of these components for autolytic behaviors. RESULTS We found two inflammatory/oxidative components were associated with BPD, characterized by high levels of JNK and ERK and low levels of GPx, SOD and Keap1; and two other inflammatory/oxidative components were linked to pED, associated with more JNK, TBARS and TNF-α and less GPx and SOD. Two components, with more JNK and ERK and less GPx, SOD and Keap1, predicted non-suicidal self-injury and three components, with higher JNK, TBARS and TNF-α levels and lower GPx, SOD and iNOS levels, predicted suicide attempts. CONCLUSIONS These results strongly support the endophenotypic characterization of impulsivity and the identification of transdiagnostic inflammatory/oxidative biomarkers relevant to autolytic behavior in impulsive and unstable disorders. These dates lay the groundwork for developing of screening tests for these biomarker components to rapidly detect biological risk factors for specific impulse control disorders and future self-injurious behaviors.
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Affiliation(s)
- J M López-Villatoro
- Institute of Health Research, Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Psychiatry and Medical Psychology, Faculty of Medicine, UCM, Madrid, Spain.
| | - A De la Torre-Luque
- Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Medical Psychology, Faculty of Medicine, UCM, Madrid, Spain
| | - K S MacDowell
- Department of Pharmacology and Toxicology, Faculty of Medicine, University Complutense de Madrid (UCM), Institute of Health Research Hospital 12 de Octubre (imas12), University Institute of Research in Neurochemistry UCM, Madrid, Spain; Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Madrid, Spain
| | - A Galvez-Merlin
- Department of Psychiatry and Medical Psychology, Faculty of Medicine, UCM, Madrid, Spain
| | - A Gómez Del Barrio
- Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Madrid, Spain; Marqués de Valdecilla University Hospital, Eating Disorders Unit, Department of Psychiatry, Santander, Spain; Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
| | | | - F Ruiz-Guerrero
- Marqués de Valdecilla University Hospital, Eating Disorders Unit, Department of Psychiatry, Santander, Spain; Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
| | - P Mola-Cardenes
- Institute of Health Research, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | | | - L Castro-Fuentes
- Marqués de Valdecilla University Hospital, Eating Disorders Unit, Department of Psychiatry, Santander, Spain
| | - J C Leza
- Department of Pharmacology and Toxicology, Faculty of Medicine, University Complutense de Madrid (UCM), Institute of Health Research Hospital 12 de Octubre (imas12), University Institute of Research in Neurochemistry UCM, Madrid, Spain; Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Madrid, Spain
| | - J L Carrasco
- Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Medical Psychology, Faculty of Medicine, UCM, Madrid, Spain
| | - M Díaz-Marsá
- Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Medical Psychology, Faculty of Medicine, UCM, Madrid, Spain
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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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Vuillier L, Greville-Harris M, Talbot CV, May L, Moseley RL. Early evaluation of a DBT-informed online intervention for people with eating disorders. J Eat Disord 2024; 12:9. [PMID: 38243262 PMCID: PMC10799469 DOI: 10.1186/s40337-024-00974-5] [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: 09/20/2023] [Accepted: 01/16/2024] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVES Eating disorders (EDs) have a worldwide prevalence of 7.8%, with towering mortality rates and high healthcare costs. The current recommended treatment for EDs principally works by directly targeting ED thoughts and behaviours, but recovery rates are low. A multifaceted link between difficulties with emotions and EDs is now widely established, and newer third-wave therapies that aim to address these underlying emotion difficulties are promising. The current study piloted an online emotion self-help intervention which was co-developed with clinicians and people with lived experienced of EDs. The intervention aimed to specifically address difficulties with emotion identification and regulation, as well as unhelpful beliefs about emotions, which are believed to give rise to and maintain ED thoughts and behaviours. METHOD We recruited 39 people with self-reported EDs to test this intervention over a one-week period. Our participants were asked to complete a series of questionnaires measuring emotion processes and psychopathology on Day 1 (T1) before being given access to the intervention. Participants were then asked to practice the newly acquired skills for seven days, before taking the same questionnaires on Day 9 (T2). We also asked participants to qualitatively report on their experience of the intervention. RESULTS We found significant improvements in ED psychopathology (ED-15), depression (PHQ-9), and anxiety (GAD-7) pre- to post-intervention, with medium to large effect sizes. All our emotion variables namely alexithymia (TAS-20), difficulties regulating emotions (DERS-SF), and unhelpful beliefs about emotions (EBQ) also showed significant changes post-intervention with medium to large effect sizes. Most importantly, changes in emotion regulation processes were linked to improved eating psychopathology. The qualitative analysis corroborated this finding, highlighting how the intervention helped them form new beliefs about emotions, which helped them reduce ED behaviours. DISCUSSION Significant improvements in emotion processing and regulations, as well as psychopathology, along with positive qualitative feedback, suggest that the intervention effectively met its aims of increasing awareness of the link between emotions and eating psychopathology, providing help to identify and regulate emotions, and normalising emotional experiences. While our results are promising, further research is required to assess its effectiveness longer term and in clinical settings.
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Affiliation(s)
- Laura Vuillier
- Department of Psychology, Bournemouth University, Poole, UK.
| | | | - C V Talbot
- Department of Psychology, Bournemouth University, Poole, UK
| | - L May
- Southern Health University NHS Foundation Trust, Southampton, UK
| | - R L Moseley
- Department of Psychology, Bournemouth University, Poole, UK
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Meneguzzo P, Ajello A, Consolati MD, Ceccato E, Vita A, Sala A, Santonastaso P. Effects of the COVID-19 pandemic on youth mental health: a cross-sectional study on eating disorder patients and their unaffected siblings. Child Adolesc Psychiatry Ment Health 2024; 18:6. [PMID: 38184616 PMCID: PMC10771694 DOI: 10.1186/s13034-023-00698-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/19/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Adolescence has emerged as a particularly vulnerable phase during the COVID-19 pandemic, with eating disorders (EDs) representing a prominent psychopathological challenge linked to the restrictions imposed by the pandemic. Emerging evidence suggests that not only individuals with EDs but also their healthy siblings (HS) may experience unique psychological effects in this context. However, the existing literature on this topic remains limited. This study seeks to examine and compare the effects of the pandemic on adolescents and adults, with a specific focus on the impact of containment measures, disruptions in daily routines, and alterations in life trajectories, for both individuals with EDs and their HS. METHODS We enrolled 273 individuals, including those diagnosed with EDs and their HS. Among the participants, 120 were under the age of 19. Multiple self-report questionnaires were administered to assess the psychological impact of 1 year of the COVID-19 pandemic. These assessments covered a range of psychological constructs, including posttraumatic symptoms, general psychopathology, and eating-related concerns. RESULTS Notably, adolescent patients with EDs demonstrated the highest psychopathological scores within our sample. They were the sole subgroup to surpass clinical cutoffs, exhibiting more pronounced issues concerning eating-related concerns and general psychological well-being. Our findings also shed light on the unique experiences of HS during the pandemic. CONCLUSION Our findings highlight the specific psychological burden endured by adolescents with EDs throughout the COVID-19 pandemic, emphasizing the vulnerability of this demographic. Moreover, the experiences of HS, often overlooked in the literature, warrant increased attention in future health programs and interventions.
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Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Via Giustiniani 2, 35128, Padua, Italy.
- Padova Neuroscience Center, University of Padova, Padua, Italy.
| | - Alessio Ajello
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Mauro Domenico Consolati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Enrico Ceccato
- Mental Health Department, Vicenza Eating Disorders Center, Azienda ULSS8 "Berica", Vicenza, Italy
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alessandra Sala
- Mental Health Department, Vicenza Eating Disorders Center, Azienda ULSS8 "Berica", Vicenza, Italy
| | - Paolo Santonastaso
- Department of Neuroscience, University of Padova, Via Giustiniani 2, 35128, Padua, Italy
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Charbonnier E, Montalescot L, Puechlong C, Goncalves A, Le Vigouroux S. Relationship between Fear of COVID-19, Intolerance of Uncertainty, and Coping Strategies on University Students' Mental Health. Nutrients 2023; 15:4938. [PMID: 38068796 PMCID: PMC10708531 DOI: 10.3390/nu15234938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND the mental health of students was particularly affected by the COVID-19 pandemic. The present study therefore examined the relationships between anxiety and depressive symptoms, eating-related problems, coping, fear of COVID-19, and intolerance of uncertainty. METHODS 2139 French students of 54 universities were recruited in the different regions of France during a French lockdown (between 21 April and 3 May 2021). Six variables were measured: fear of COVID-19, intolerance of uncertainty, coping, anxiety and depressive symptoms, and eating-related problems. To explore the directions of the relationships between our variables of interest, we calculated a directed acyclic graph. RESULTS our data highlighted the central roles of intolerance of uncertainty in students' anxiety and depressive symptoms, and the direct role of prospective intolerance of uncertainty on eating-related problems. CONCLUSIONS these findings indicate that intolerance of uncertainty should be targeted by interventions designed to help students with high levels of anxiety, depressive symptoms, and/or eating-related problems.
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Affiliation(s)
- Elodie Charbonnier
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, France; (L.M.); (C.P.); (A.G.); (S.L.V.)
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Zhu HY, Guo YM, Pan ZM, Wang Y, Zhang ML, Zhu RH, Li ZP, Wang Z. Long-term effects of the COVID-19 pandemic on five mental and psychological disorders: in terms of the number of disease visits, drug consumption, and scale scores. BMC Psychiatry 2023; 23:677. [PMID: 37723474 PMCID: PMC10506188 DOI: 10.1186/s12888-023-05166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 09/04/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND COVID-19 caused mild to severe infections in humans. The long-term epidemic environment harms people's mental health. To explore the impact of the epidemic on people's mental and psychological conditions, we surveyed in Wenzhou. METHODS We collected the data of people who visited the First Affiliated Hospital of Wenzhou Medical University for five types of mental and psychological diseases from January 2018 to December 2021. Then, taking December 2019 as the cut-off point, the 48-month data were divided into the pre-epidemic group and the dur-epidemic group. Based on the above data, statistical analysis was done. RESULTS From 2018 to 2021, the number of initial diagnoses, the number of disease visits, and drug consumption for these five types of mental and psychological diseases were all on the rise. Compared with the number of disease visits for all disorders in both psychiatry and neurology departments, it was found that the growth rate of these five diseases was higher than the growth rate of all disorders. We found that the number of disease visits, drug consumption, and scale scores after the COVID-19 outbreak were significantly different from those before the outbreak (P < 0.05). And the number of disease visits positively correlated with drug consumption (P < 0.0001, r = 0.9503), which verified the stability of the data. CONCLUSION The epidemic environment has had a long-term and negative impact on people's mental and psychological conditions. Therefore, whether or not the epidemic is receding, we still need to be concerned about the impact of COVID-19 on mental and psychological health.
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Affiliation(s)
- Han-Yu Zhu
- Department of Neurology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang, 324000, China
| | - Yi-Mo Guo
- The Second Clinical College, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Zhi-Ming Pan
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
- The First Clinical College, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Yan Wang
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
- The First Clinical College, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Meng-Li Zhang
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
- The First Clinical College, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Ru-Huang Zhu
- Department of Gynecology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Zhang-Ping Li
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang, 324000, China.
| | - Zhen Wang
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
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Vogel M, Gil A, Galaz C, Urrejola P, Lacalle L, Jara R, Irribarra V, Letelier M, Costa D, Espinoza G. Virtually Accompanied Eating in the Outpatient Therapy of Anorexia Nervosa. Nutrients 2023; 15:3783. [PMID: 37686815 PMCID: PMC10489725 DOI: 10.3390/nu15173783] [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: 07/04/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Normalizing the eating pattern and weight recovery are the main objectives in treating anorexia nervosa (AN). Eating accompaniment through shared mealtimes is a common strategy in eating disorder management programs. This study aims to examine the impact on weight gain of an internet-delivered meal support group on patients with AN who were under ambulatory treatment with the Eating Disorders Unit of the UC Christus Health Network, Chile. METHODS An observational study of 54 female patients with AN diagnosis who participated in Online Meal Support Groups (OMSGs) three times a week was performed. Their weight, BMI and BMI%, was reviewed at the beginning of the sessions and at 45- and 90-day follow-up. RESULTS Patients showed significant weight gain during follow-up. At the 90-day follow-up, patients had gained 4.41 (SD ± 2.82) kg with an effect size of -1.563. CONCLUSIONS Statistically significant differences were found between the weight at the beginning of the intervention and at the 45- and 90-day follow-up, meaning that eating support online groups may be an effective intervention for weight gain and maintenance in patients with AN. These findings highlight the viability of developing cost-effective and more accessible interventions for AN and thus help reduce the duration of untreated disease and its consequences.
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Affiliation(s)
- Melina Vogel
- Eating Disorders Unit of the UC Christus Health Network, Santiago 8330077, Chile; (M.V.); (A.G.); (C.G.); (P.U.); (L.L.); (R.J.); (V.I.); (M.L.); (D.C.)
- Psychiatry Department, Faculty of Medicine, Pontificia Universidad Catolica, Santiago 8330077, Chile
| | - Aurora Gil
- Eating Disorders Unit of the UC Christus Health Network, Santiago 8330077, Chile; (M.V.); (A.G.); (C.G.); (P.U.); (L.L.); (R.J.); (V.I.); (M.L.); (D.C.)
| | - Camila Galaz
- Eating Disorders Unit of the UC Christus Health Network, Santiago 8330077, Chile; (M.V.); (A.G.); (C.G.); (P.U.); (L.L.); (R.J.); (V.I.); (M.L.); (D.C.)
| | - Pascuala Urrejola
- Eating Disorders Unit of the UC Christus Health Network, Santiago 8330077, Chile; (M.V.); (A.G.); (C.G.); (P.U.); (L.L.); (R.J.); (V.I.); (M.L.); (D.C.)
- Adolescent Unit, Pediatrics Department, Faculty of Medicine, Pontificia Universidad Catolica, Santiago 8330077, Chile
| | - Lucas Lacalle
- Eating Disorders Unit of the UC Christus Health Network, Santiago 8330077, Chile; (M.V.); (A.G.); (C.G.); (P.U.); (L.L.); (R.J.); (V.I.); (M.L.); (D.C.)
| | - Raúl Jara
- Eating Disorders Unit of the UC Christus Health Network, Santiago 8330077, Chile; (M.V.); (A.G.); (C.G.); (P.U.); (L.L.); (R.J.); (V.I.); (M.L.); (D.C.)
| | - Verónica Irribarra
- Eating Disorders Unit of the UC Christus Health Network, Santiago 8330077, Chile; (M.V.); (A.G.); (C.G.); (P.U.); (L.L.); (R.J.); (V.I.); (M.L.); (D.C.)
- Nutrition and Diabetes Department, Faculty of Medicine, Pontificia Universidad Catolica, Santiago 8330077, Chile
| | - Matias Letelier
- Eating Disorders Unit of the UC Christus Health Network, Santiago 8330077, Chile; (M.V.); (A.G.); (C.G.); (P.U.); (L.L.); (R.J.); (V.I.); (M.L.); (D.C.)
| | - Daniela Costa
- Eating Disorders Unit of the UC Christus Health Network, Santiago 8330077, Chile; (M.V.); (A.G.); (C.G.); (P.U.); (L.L.); (R.J.); (V.I.); (M.L.); (D.C.)
| | - Gabriela Espinoza
- Eating Disorders Unit of the UC Christus Health Network, Santiago 8330077, Chile; (M.V.); (A.G.); (C.G.); (P.U.); (L.L.); (R.J.); (V.I.); (M.L.); (D.C.)
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12
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Bonfanti RC, Sideli L, Teti A, Musetti A, Cella S, Barberis N, Borsarini B, Fortunato L, Sechi C, Micali N, Lo Coco G. The Impact of the First and Second Wave of the COVID-19 Pandemic on Eating Symptoms and Dysfunctional Eating Behaviours in the General Population: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:3607. [PMID: 37630798 PMCID: PMC10458761 DOI: 10.3390/nu15163607] [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: 07/26/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The aim of this systematic review and meta-analysis was to examine the prevalence of feeding and eating disorder (FED) symptoms or dysfunctional eating behaviours (DEB) in the general population during the COVID-19 outbreak. METHOD We searched eligible articles in biomedical databases from 1 January 2020 to 31 March 2022. Prevalence rates of FED or DEB changes between pre-pandemic and pandemic time and correlation with psychological distress were pooled with a meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. A total of 186 studies with 406,076 participants met the inclusion criteria. RESULTS The more prevalent FED or DEB during the COVID-19 outbreak were: body image concerns (52%, 95% CI 0.38, 0.66), binge eating (40%, 95% CI 0.25, 0.55), and overeating (40%, 95% CI = 0.32-0.48). Pooled data of longitudinal studies (k = 8) only showed a significant difference in the prevalence of weight gain from pre-pandemic to the pandemic time. Finally, increased levels of psychological distress (k = 35) positively correlated with some ED symptoms. CONCLUSION This meta-analysis evidenced a negative impact of the pandemic on eating symptoms and DEB in the general population.
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Affiliation(s)
| | - Lucia Sideli
- Department of Human Science, LUMSA University, 00193 Rome, Italy;
| | - Arianna Teti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy; (A.T.); (L.F.); (G.L.C.)
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, 43121 Parma, Italy
| | - Stefania Cella
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy;
| | - Nadia Barberis
- Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Bianca Borsarini
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, 2750 Ballerup, Denmark; (B.B.); (N.M.)
| | - Lucia Fortunato
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy; (A.T.); (L.F.); (G.L.C.)
| | - Cristina Sechi
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy;
| | - Nadia Micali
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, 2750 Ballerup, Denmark; (B.B.); (N.M.)
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy; (A.T.); (L.F.); (G.L.C.)
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13
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Sahlan RN, Kinkel-Ram SS, Uzoegwu K, Smith A. Fear of COVID-19, insomnia, and eating disorder symptoms among Iranian college students. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 13:100601. [PMID: 37234278 PMCID: PMC10198744 DOI: 10.1016/j.jadr.2023.100601] [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: 12/21/2022] [Revised: 04/10/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023] Open
Abstract
Objective Eating disorders (EDs), fear of COVID-19, and insomnia have all increased during the COVID-19 pandemic in Western societies. Additionally, fear of COVID-19 and sleep disturbances relate to ED symptoms in Western societies. However, it is unknown whether fear of COVID-19 and insomnia relate to ED symptoms in non-Western countries, such as Iran. Thus, this study examined the relation between fear of COVID-19, insomnia, and ED symptoms among Iranian college students. Specifically, we hypothesized that insomnia and fear of COVID-19 would each uniquely relate to ED symptoms and the interaction between insomnia and fear of COVID-19 would also associate with increased ED symptoms. Method College students (N =1,043) filled out measures assessing fear of COVID-19, insomnia, and ED symptoms. We ran moderation analyses using linear regression for global ED symptoms and negative binomial regressions for binge eating and purging. Results Fear of COVID-19 and insomnia had unique effects on global ED symptoms and binge eating. Insomnia, but not fear of COVID-19, had a unique effect on purging. No significant interaction effect was found. Discussion This study was the first to examine the association between fear of COVID-19 and insomnia on ED symptoms in Iran. Fear of COVID-19 and insomnia should be incorporated into novel assessments and treatments for EDs.
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Affiliation(s)
- Reza N Sahlan
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo-SUNY, Buffalo, NY, United States
| | | | - Kelechi Uzoegwu
- Miami University, Department of Psychology, Oxford, Ohio, United States
| | - April Smith
- Auburn University, Department of Psychology, Auburn, AL, United States
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14
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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: 4] [Impact Index Per Article: 4.0] [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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15
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Couturier J, Pellegrini D, Grennan L, Nicula M, Miller C, Agar P, Webb C, Anderson K, Barwick M, Dimitropoulos G, Findlay S, Kimber M, McVey G, Lock J. Multidisciplinary implementation of family-based treatment delivered by videoconferencing (FBT-V) for adolescent anorexia nervosa during the COVID-19 pandemic. Transl Behav Med 2023; 13:85-97. [PMID: 36327378 PMCID: PMC9972350 DOI: 10.1093/tbm/ibac086] [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] [Indexed: 11/06/2022] Open
Abstract
Family-Based Treatment (FBT)-the most widely supported treatment for pediatric eating disorders-transitioned to virtual delivery in many programs due to COVID-19. Using a blended implementation approach, we systematically examined therapist adherence to key components of FBT and fidelity to FBT by videoconferencing (FBT-V), preliminary patient outcomes, and team experiences with our FBT-V implementation approach as well as familial perceptions of FBT-V effectiveness. We examined our implementation approach across four pediatric eating disorder programs in Ontario, Canada, using mixed methods. Participants included therapists (n = 8), medical practitioners (n = 4), administrators (n = 6), and families (n = 5; 21 family members in total). We developed implementation teams at each site, provided FBT-V training, and offered clinical and implementation consultation. Therapists submitted video recordings of their first four FBT-V sessions for fidelity rating, and patient outcomes. Therapists self-reported readiness, attitudes, confidence, and adherence to FBT-V. Focus groups were conducted with each team and family after the first four sessions of FBT-V. Quantitative data were analyzed using repeated measures ANOVA. Qualitative data were analyzed using directed and summative content analysis. Therapists adhered to key FBT components and maintained FBT-V fidelity. Changes in therapists' readiness, attitudes, and confidence in FBT-V over time were not significant. All patients gained weight. Focus groups revealed implementation facilitators/barriers, positives/negatives surrounding FBT-V training and consultation, suggestions for improvement, and effectiveness attributed to FBT-V. Our implementation approach appeared to be feasible and acceptable. Future research with a larger sample is required, furthering our understanding of this approach and exploring how organizational factors influence treatment fidelity.
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Affiliation(s)
- Jennifer Couturier
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Eating Disorder Program, McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Danielle Pellegrini
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Laura Grennan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Maria Nicula
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Catherine Miller
- Eating Disorder Program, Canadian Mental Health Association, Waterloo Wellington, Kitchener, ON, Canada
| | - Paul Agar
- Eating Disorder Program, McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Cheryl Webb
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Eating Disorder Program, McMaster Children’s Hospital, Hamilton, ON, Canada
| | | | - Melanie Barwick
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, ON, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Sheri Findlay
- Eating Disorder Program, McMaster Children’s Hospital, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Gail McVey
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, ON, Canada
- Ontario Community Outreach Program for Eating Disorders, University Health Network, Toronto, ON, Canada
| | - James Lock
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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16
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Strodl E, Sorensen P. The role of metacognitive beliefs versus meta-emotion beliefs in disordered eating. AUSTRALIAN PSYCHOLOGIST 2023. [DOI: 10.1080/00050067.2023.2181685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Patrick Sorensen
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
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17
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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: 10] [Impact Index Per Article: 10.0] [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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18
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Machado BC, Moreira CS, Correia M, Veiga E, Gonçalves S. Coping as a Mediator and Moderator between Psychological Distress and Disordered Eating Behaviors and Weight Changes during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2504. [PMID: 36767871 PMCID: PMC9915561 DOI: 10.3390/ijerph20032504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Previous research has already shown the negative impact of the COVID-19 pandemic on college students' well-being and mental health. Eating problems and weight gain due to changes in eating habits and physical activity experienced during this period have also been noticed. However, few studies have explored the role of students' resources as used during the COVID-19 pandemic, such as coping strategies. This study aimed to (1) explore the associations among psychological distress, disordered eating, coping strategies, and weight changes; (2) examine the moderating role of coping strategies in the process of weight gain and weight loss; and (3) study the mediating role of coping strategies in the process of weight gain and weight loss. The participants in this study were 772 students at a Portuguese university. The data collected included sociodemographic data and three self-reported questionnaires (Depression, Anxiety, and Stress Scale; Eating Disorder Examination Questionnaire; Brief COPE) during the first few months of the pandemic, which included a 72-day full national lockdown. The results showed that depression, anxiety, stress, and disordered eating were related to increased weight. Guilt, denial, self-distraction, use of substances, and behavior disinvestment were also related to increased weight. Behavioral disinvestment had a strong mediating effect on weight gain. Additionally, planning, positive reframing, and acceptance all showed a moderating effect between psychological distress and weight changes. In conclusion, coping strategies allow for a better understanding of the mechanisms by which psychological distress and disordered eating were related to weight changes during the pandemic.
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Affiliation(s)
- Bárbara Cesar Machado
- CEDH—Research Centre for Human Development, Faculdade de Educação e Psicologia, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
| | - Célia S. Moreira
- Centre of Mathematics & Faculty of Sciences, University of Porto (CMUP & FCUP), 4169-007 Porto, Portugal
| | - Marta Correia
- Escola Superior de Biotecnologia, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
| | - Elisa Veiga
- CEDH—Research Centre for Human Development, Faculdade de Educação e Psicologia, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
| | - Sónia Gonçalves
- School of Psychology, University of Minho, 4710-057 Braga, Portugal
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19
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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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20
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Portingale J, Eddy S, Fuller-Tyszkiewicz M, Liu S, Giles S, Krug I. Tonight, I'm disordered eating: The effects of food delivery app use, loneliness, and mood on daily body dissatisfaction and disordered eating urges. Appetite 2023; 180:106310. [PMID: 36122621 DOI: 10.1016/j.appet.2022.106310] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 08/03/2022] [Accepted: 09/10/2022] [Indexed: 12/15/2022]
Abstract
With the recent proliferation of food delivery applications ('apps'; FDAs), accessing a meal is more convenient and immediate than ever. However, these apps may foster dysregulated eating behaviours, including maladaptive eating to cope with negative emotional states. Using ecological momentary assessment (EMA), the current study assessed whether FDA use at baseline predicted levels of EMA-assessed disordered eating urges and body dissatisfaction, whether negative mood and loneliness impacted disordered eating urges and body dissatisfaction at the state level, and whether the latter relationships were moderated by FDA usage frequency. Participants (N = 483; 78.7% women; 20.1% men; 1.2% other) completed a baseline questionnaire and were characterised as current FDA users (49.3%) or non-users (50.7%). Participants then completed a smartphone-facilitated investigation into their experiences of loneliness, negative mood, body dissatisfaction, and disordered eating urges, six times per day for 7-days. Across the entire sample, current FDA users at baseline reported greater EMA-assessed urges to overeat. At the state level, loneliness and negative mood predicted greater body dissatisfaction, with the latter also predicting greater urges for restrictive eating and overeating. Among current FDA users at baseline, at the state level, loneliness predicted greater body dissatisfaction, and negative mood predicted greater body dissatisfaction and urges for overeating. No moderating effects were observed for baseline FDA usage frequency. These results elucidate FDA use and daily experiences of loneliness and negative mood as factors elevating eating disorder (ED)-related risk. Further extensions of this research with nuanced measures of state FDA use are required.
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Affiliation(s)
- Jade Portingale
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.
| | - Sarah Eddy
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, VIC, Australia; Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
| | - Shanshan Liu
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Sarah Giles
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Falco CB, Peres MADA, Appolinario JC, Menescal LL, Tavares IDGAM. Consulta remota a pessoas com transtornos alimentares durante a pandemia de COVID-19. Rev Bras Enferm 2023. [DOI: 10.1590/0034-7167-2022-0197pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
RESUMO Objetivos: analisar as experiências subjetivas relacionadas à adaptação ao atendimento remoto por usuários com transtornos alimentares durante a pandemia de COVID-19. Métodos: estudo descritivo de abordagem qualitativa realizado com usuários de um ambulatório especializado em transtornos alimentares. Foi aplicada uma entrevista semiestruturada remota, utilizando-se o aplicativo Google Meet. Os dados foram submetidos à análise lexical por meio do software ALCESTE e discutidos à luz das evidências científicas. Resultados: a consulta remota é uma estratégia positiva, mas não substitutiva da modalidade presencial. Vantagens como economia financeira, maior contato com os profissionais e flexibilização de horários de atendimentos foram citadas. Dificuldade de avaliação clínica em relação ao peso, sinais vitais e pouco domínio da tecnologia foram apontados como limitações. Considerações Finais: o estudo induz a discussão sobre sistematização dos atendimentos remotos, os quais, durante a pandemia de COVID-19, foram responsáveis por fornecer maior sensação de suporte às pessoas com transtornos alimentares.
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22
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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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23
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Falco CB, Peres MADA, Appolinario JC, Menescal LL, Tavares IDGAM. Remote consultation with people with eating disorders during the COVID-19 pandemic. Rev Bras Enferm 2023; 76Suppl 1:e20220197. [DOI: 10.1590/0034-7167-2022-0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
ABSTRACT Objectives: to analyze subjective experiences related to adaptation to remote care by users with eating disorders during the COVID-19 pandemic. Methods: a descriptive study with a qualitative approach conducted with users of an eating disorders outpatient clinic. A semi-structured remote interview was applied using the Google Meet application. The data were submitted to lexical analysis using ALCESTE software and discussed in the light of scientific evidence. Results: the remote appointment is a positive strategy but not a substitute for the face-to-face modality. The research cited financial savings, closer contact with professionals, and flexibility of service schedules as advantages. It pointed out the difficulty in clinical evaluation concerning weight, vital signs, and poor mastery of technology as limitations. Final Considerations: the study induces discussion about the systematization of remote care, which, during the COVID-19 pandemic, were responsible for providing a greater sense of support to people with eating disorders.
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24
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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] [MESH Headings] [Grants] [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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25
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Vuillier L, Joseph J, Greville-Harris M, May L, Somerville MP, Harrison A, Moseley RL. What about males? Exploring sex differences in the relationship between emotion difficulties and eating disorders. J Eat Disord 2022; 10:193. [PMID: 36514166 PMCID: PMC9749243 DOI: 10.1186/s40337-022-00715-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE While eating disorders (EDs) are more commonly diagnosed in females, there is growing awareness that men also experience EDs and may do so in a different way. Difficulties with emotion processing and emotion regulation are believed to be important in EDs, but as studies have involved predominantly female samples, it is unclear whether this is also true for males. METHODS In a sample of 1604 participants (n = 631 males), we assessed emotion processing and emotion regulation in males with EDs (n = 109) and compared results to both females with EDs (n = 220) and males from the general population (n = 522). We also looked at whether emotion processing and emotion regulation difficulties predicted various aspects of eating psychopathology and whether this was moderated by sex. We assessed emotion processing with the Toronto Alexithymia Scale, emotion regulation with the Difficulties in Emotion Regulation Scale and the Emotion Regulation Questionnaire, and eating psychopathology with the Eating Disorder Examination Questionnaire. RESULTS We found that males with ED, like their female counterparts, suffered from emotion processing and emotion regulation deficits. We did find some sex differences, in that males with EDs tended to report more difficulties with their emotions as well as a more externally oriented thinking style compared to females with EDs. Difficulties with emotion processing and emotion regulation were strongly predictive of various aspects of eating psychopathology in both sexes. Importantly, we found that sex moderated the relationship between cognitive reappraisal and eating restraint. As such, low use of reappraisal was found to be associated with higher levels of restraint in females but not in males. DISCUSSION Difficulties with emotion processing and emotion regulation are associated with eating psychopathology in both males and females. Reappraisal was not found to be associated with reduced eating psychopathology in males, suggesting a cautious approach to interventions targeting this strategy. Research around explanatory mechanisms and interventions must adopt a broader viewpoint including those that are traditionally overlooked in EDs.
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Affiliation(s)
- L Vuillier
- Department of Psychology, Bournemouth University, Poole, UK.
| | - J Joseph
- Department of Psychology, Bournemouth University, Poole, UK
| | | | - L May
- Dorset Healthcare University NHS Foundation Trust, Poole, UK
| | - M P Somerville
- UCL Institute of Education, University College London, London, UK
| | - A Harrison
- UCL Institute of Education, University College London, London, UK
| | - R L Moseley
- Department of Psychology, Bournemouth University, Poole, UK
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26
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Erdoğan S, Can AA, Abiç A, Yilmaz DV. Examination of individuals' depression, anxiety, and stress levels during the COVID-19 pandemic in Turkey. Arch Psychiatr Nurs 2022; 41:96-102. [PMID: 36428081 PMCID: PMC9307468 DOI: 10.1016/j.apnu.2022.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/31/2022] [Accepted: 07/10/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE This research was conducted to determine the depression, anxiety, and stress levels of individuals during the COVID-19 epidemic. In addition, the compatibility of the Depression-Anxiety-Stress Scale (DASS-21) scale results with the participants' feeling depressed, anxious, and stressed were examined. DESIGN AND METHODS The sample of the study consisted of 870 individuals over the age of 18 between May-August 2021. The data of the study were collected online, using the personal information form and DASS-21. RESULTS In our study, it was observed that 22.3 % of the participants were severely depressed, 19.0 % were highly anxious and 14.3 % were highly stressed. In addition, a relationship was determined between many sociodemographic variables and depression, anxiety, and stress levels. It was found that individuals who were not vaccinated, did not receive health care, and were not satisfied with health care were more depressed, anxious, and stressed. The agreement between all DASS-21 sub-dimensions and participants' feeling is poor in terms of Cohen's kappa. The agreement is poor in the anxiety sub dimension, but moderate in the other sub-dimensions in terms of Gwet's AC1. PRACTICE IMPLICATIONS It is recommended that nurses develop new care and evaluation strategies for the psychosocial field in order to protect and maintain the health of individuals during the COVID-19 pandemic process, as well as more practices promoting the COVID-19 vaccine in our country.
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Affiliation(s)
- Semra Erdoğan
- Department of Biostatistics and Medical Informatics, Mersin University Faculty of Medicine, 33343 Mersin, Turkey.
| | - Ahu Aksoy Can
- Department of Obstetrics and Gynecology Nursing, Mersin University Faculty of Nursing, 33343 Mersin, Turkey
| | - Arzu Abiç
- Department of Nursing, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus, via Mersin 10, Turkey.
| | - Duygu Vefikuluçay Yilmaz
- Department of Obstetrics and Gynecology Nursing, Mersin University Faculty of Nursing, 33343 Mersin, Turkey; Department of Obstetrics and Gynecology Nursing, Mersin University Faculty of Nursing, Mersin, 33343 Mersin, Turkey
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27
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Effects of the COVID-19 Restrictions on Eating Behaviour and Eating Disorder Symptomology in Female Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148480. [PMID: 35886334 PMCID: PMC9325224 DOI: 10.3390/ijerph19148480] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 12/10/2022]
Abstract
Confinement due to the COVID-19 pandemic imposes a burden on adolescents worldwide and may seriously impact patients with an eating disorder (ED). The current FRanconian Anorexia Nervosa during COVID-19 (FRANCO) study explored (1) perceived change of depressive and ED symptomology during lockdown, (2) the role of social media, and (3) coping strategies of anorexia nervosa (AN) patients and clinical as well as healthy comparison groups. From June 2021 to September 2021, 222 female adolescents (19 with AN, 20 with depression, 45 with a self-reported psychiatric disorder (SRPD), and 138 controls) aged 11.2 to 18.9 years completed a one-time anonymous survey retrospectively reporting back on ED and depressive symptomology before and during the pandemic, the impact of social media, and coping strategies. A reduced quality of life (QoL) due to confinement was observed in almost half of female adolescents. All groups reported a significant perceived increase of disordered eating, overeating, anxiety, and depressive symptoms and emotion-regulation problems. In AN patients, significantly higher percentual deterioration of disordered eating and anxiety and depressive symptoms was found. For controls, a younger age and higher susceptibility of the sociocultural body image significantly correlated with increased disordered eating. Large-scale media literacy interventions are recommended.
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28
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J. Devoe D, Han A, Anderson A, Katzman DK, Patten SB, Soumbasis A, Flanagan J, Paslakis G, Vyver E, Marcoux G, Dimitropoulos G. The impact of the COVID-19 pandemic on eating disorders: A systematic review. Int J Eat Disord 2022; 56:5-25. [PMID: 35384016 PMCID: PMC9087369 DOI: 10.1002/eat.23704] [Citation(s) in RCA: 120] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE A growing body of evidence suggests that individuals with eating disorders (EDs) have experienced deteriorating symptoms, increased isolation, and an increase in hospital admissions as a result of the COVID-19 pandemic. Despite this, no systematic reviews have been conducted examining the COVID-19 and ED peer-reviewed literature. Therefore, this systematic review aimed to synthesize the impact of the COVID-19 pandemic on individuals with EDs. METHOD Database searches of the peer-reviewed literature were completed in the subsequent databases: CINAHL, Embase, MEDLINE, and PsycINFO (from November 2019 to October 20, 2021). All research reporting on the relationship between the COVID-19 pandemic on individuals with EDs were included. RESULTS Fifty-three studies met the inclusion criteria, including 36,485 individuals with EDs. The pooled hospital admissions across the studies demonstrated on average a 48% (pre = 591, post = 876, n = 10 studies) increase in admissions during the pandemic compared to previous pre-pandemic timepoints. In this review, 36% of studies (n = 19) documented increases in eating disorder symptoms during the pandemic, this increase in eating disorder symptoms were documented in AN, BED, BN, and OFSED patients. Studies also demonstrated increases in anxiety (n = 9) and depression (n = 8), however patterns of change appeared to be diagnostic and timing specific (e.g., lockdowns). DISCUSSION We found a large increase in the number of hospitalizations and an increase in ED symptoms, anxiety, depression, and changes to BMI in ED patients during the pandemic. However, these changes appeared to be diagnostic and timing specific. Many qualitative studies described deterioration in ED symptomatology due to decreased access to care and treatment, changes to routine and loss of structure, negative influence of the media, and social isolation. Future studies are needed to focus on pediatric populations, new ED diagnoses, and severity of illness at presentation. PUBLIC SIGNIFICANCE The scientific literature suggests that individuals with eating disorders have experienced deteriorating symptoms, increased isolation, and an increase in hospital admissions as a result of the COVID-19 pandemic. This study synthesized 53 articles and explored the impact of the COVID-19 pandemic on patients with eating disorders. We found increases in eating disorder symptoms during the pandemic; this increase in eating disorder symptoms was documented in patients with common eating disorders including anorexia nervosa, binge-eating disorder, bulimia nervosa, and other specified feeding and eating disorders. This review also demonstrated changes in body mass index (an index used to classify underweight, overweight, and obesity in adults) and increases in anxiety and depression during the pandemic compared to previous timepoints; patterns of change appeared to be related to timing of lockdowns. This review provides important information on the impact of COVID-19 on the physical and mental health of individuals with eating disorders.
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Affiliation(s)
- Daniel J. Devoe
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada,Department of PsychologyMount Royal UniversityCalgaryCanada
| | - Angela Han
- Division of Adolescent Medicine, Department of PediatricsThe Hospital for Sick Children, University of TorontoTorontoONCanada
| | - Alida Anderson
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada
| | - Debra K. Katzman
- Division of Adolescent Medicine, Department of PediatricsThe Hospital for Sick Children, University of TorontoTorontoONCanada
| | - Scott B. Patten
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada
| | - Andrea Soumbasis
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada
| | - Jordyn Flanagan
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and PsychotherapyRuhr‐University BochumLübbeckeGermany
| | | | | | - Gina Dimitropoulos
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada,Faculty of Social WorkUniversity of CalgaryCalgaryABCanada
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Rapid Evidence Review of Community Engagement and Resources in the UK during the COVID-19 Pandemic: How Can Community Assets Redress Health Inequities? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074086. [PMID: 35409769 PMCID: PMC8998387 DOI: 10.3390/ijerph19074086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/14/2022] [Accepted: 03/24/2022] [Indexed: 12/14/2022]
Abstract
Community engagement, such as participating in arts, nature or leisurely activities, is positively associated with psychological and physiological wellbeing. Community-based engagement during the COVID-19 pandemic facilitated informal and local mutual aid between individuals. This rapid evidence review assesses the emergence of community-based arts, nature, music, theatre and other types of cultural engagement amongst UK communities in response to the COVID-19 pandemic. Here, we focus on all community engagement with a sub-focus on provisions accessed by and targeted towards vulnerable groups. Two hundred and fifty-six resources were included that had been created between February 2020 and January 2021. Resources were identified through Google Scholar, PubMed, Web of Science, MedRXic, PsycharXiv and searches for grey literature and items in the public domain. The majority reported services that had been adapted to become online, telephone-based or delivered at a distance from doorsteps. Several quality assessment frameworks were used to evaluate the quality of data. Whilst a number of peer-reviewed, grey literature and public domain articles were identified, less than half of the identified literature met quality thresholds. The pace of the response to the pandemic may have meant that robust evaluation procedures were not always in place.
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Schneider J, Pegram G, Gibson B, Talamonti D, Tinoco A, Craddock N, Matheson E, Forshaw M. A mixed-studies systematic review of the experiences of body image, disordered eating, and eating disorders during the COVID-19 pandemic. Int J Eat Disord 2022; 56:26-67. [PMID: 35322449 PMCID: PMC9087368 DOI: 10.1002/eat.23706] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/05/2022] [Accepted: 03/05/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES This systematic review assessed the influence of the COVID-19 pandemic and associated restrictions on body image, disordered eating (DE), and eating disorder outcomes. METHODS After registration on PROSPERO, a search was conducted for papers published between December 1, 2019 and August 1, 2021, using the databases PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley, and ProQuest (dissertations and theses). RESULTS Data from 75 qualitative, quantitative, and mixed-methods studies were synthesized using a convergent integrated approach and presented narratively within four themes: (1) disruptions due to the COVID-19 pandemic; (2) variability in the improvement or exacerbation of symptoms; (3) factors associated with body image and DE outcomes; (4) unique challenges for marginalized and underrepresented groups. Disruptions due to the pandemic included social and functional restrictions. Although most studies reported a worsening of concerns, some participants also reported symptom improvement or no change as a result of the pandemic. Factors associated with worse outcomes included psychological, individual, social, and eating disorder-related variables. Individuals identifying as LGBTQ+ reported unique concerns during COVID-19. DISCUSSION There is large variability in individuals' responses to COVID-19 and limited research exploring the effect of the pandemic on body image, DE, and eating disorder outcomes using longitudinal and experimental study designs. In addition, further research is required to investigate the effect of the COVID-19 pandemic on body image and eating concerns among minoritized, racialized, underrepresented, or otherwise marginalized participants. Based on the findings of this review, we make recommendations for individuals, researchers, clinicians, and public health messaging. PUBLIC SIGNIFICANCE This review of 75 studies highlights the widespread negative impacts that the COVID-19 pandemic and associated restrictions have had on body image and disordered eating outcomes. It also identifies considerable variations in both the improvement and exacerbation of said outcomes that individuals, researchers, clinicians, and other public health professionals should be mindful of if we are to ensure that vulnerable people get the tailored support they require.
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Affiliation(s)
- Jekaterina Schneider
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Georgina Pegram
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Benjamin Gibson
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Deborah Talamonti
- Research Centre and Centre EPICMontreal Heart InstituteMontrealQuebecCanada
| | - Aline Tinoco
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Nadia Craddock
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Emily Matheson
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Mark Forshaw
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
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31
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Weissman RS, Hay P. People's lived experience with an eating disorder during the COVID-19 pandemic: A joint virtual issue of research published in leading eating disorder journals. Int J Eat Disord 2022; 55:155-160. [PMID: 35099825 PMCID: PMC9015291 DOI: 10.1002/eat.23653] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/21/2021] [Accepted: 11/29/2021] [Indexed: 12/30/2022]
Abstract
The COVID-19 pandemic has profoundly disrupted people's daily life and contributed to adverse health and mental health outcomes. People with pre-existing mental health conditions are particularly likely to experience symptom exacerbation. Complementing the adverse impacts of the pandemic are eating disorder specific risk factors for worsening of eating disorder symptoms and/or impeding treatment progress and recovery. For this joint Virtual Issue, we selected 15 articles that have been published in two leading journals in the field of eating disorders (International Journal of Eating Disorders and Journal of Eating Disorders) to highlight studies that offer information about individuals' lived experience with an eating disorder during the COVID-19 pandemic. In these studies, most participants reported worsening of eating disorder symptoms which they attributed to challenges arising from changes in daily routines including eating and exercise related habits, increased stress, and diminished social contacts. These research findings reported a mixed picture about patients' perceptions of the ease of the transition to virtual delivery of treatment and the quality of care they received during the pandemic. Qualitative studies suggested strategies for supporting people with eating disorders during pandemic conditions, with some of these holding promise for improving care for individuals who experience an eating disorder.
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Affiliation(s)
| | - Phillipa Hay
- Translational Health Research Institute, School of MedicineWestern Sydney UniversityPenrithNew South WalesAustralia
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32
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Năstăsescu V, Mititelu M, Stanciu TI, Drăgănescu D, Grigore ND, Udeanu DI, Stanciu G, Neacșu SM, Dinu-Pîrvu CE, Oprea E, Ghica M. Food Habits and Lifestyle of Romanians in the Context of the COVID-19 Pandemic. Nutrients 2022; 14:nu14030504. [PMID: 35276862 PMCID: PMC8839677 DOI: 10.3390/nu14030504] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
The pandemic caused by the SARS-CoV-2 virus has produced significant changes in socio-cultural life, diet, and interpersonal relationships across the world’s population. The present study aims to identify changes in lifestyle and diet among the Romanian population one year after the onset of the COVID-19 pandemic. An online questionnaire with 58 items (addressing the following aspects: socio-demographic and anthropometric data, current eating habits, and lifestyle changes) was distributed using institutional mailing lists and social media. A total number of 2040 respondents participated in the study, of whom 1464 were women, and 576 men. Among the respondents, 1598 came from urban areas and 442 from rural areas. The processing of the collected data showed significant changes in the behavior of the respondents caused by the pandemic situation with psycho-affective changes in some cases. The number of people who had anxiety, depression and nervousness increased by up to 20%. The majority of respondents (over 57%) were up to 30 years old, either students (43.50%) or employees going to workplaces (33.20%). Analyzing eating habits, we found that diet modification was needed to increase the daily consumption of fruits, vegetables, fish, and seafood. Regarding weight status during the pandemic, we noticed that 34.7% of normal-weight respondents said that they gained weight while 49.7% of overweight people and 52.5% of obese people said that they gained weight (p < 0.0001). Regarding psycho-emotional behavior, 11.81% of the surveyed women stated that they frequently had depressive states during the pandemic period and 11.63% of the men stated that they frequently presented depressive states during the pandemic (p = 0.005).
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Affiliation(s)
- Valentin Năstăsescu
- Department of Physical and Colloidal Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy Carol Davila, 020956 Bucharest, Romania; (V.N.); (C.E.D.-P.)
| | - Magdalena Mititelu
- Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, University of Medicine and Pharmacy Carol Davila, 020956 Bucharest, Romania; (N.D.G.); (D.I.U.)
- Correspondence: (M.M.); (G.S.)
| | | | - Doina Drăgănescu
- Pharmaceutical Physics and Informatics Department, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania;
| | - Nicoleta Diana Grigore
- Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, University of Medicine and Pharmacy Carol Davila, 020956 Bucharest, Romania; (N.D.G.); (D.I.U.)
| | - Denisa Ioana Udeanu
- Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, University of Medicine and Pharmacy Carol Davila, 020956 Bucharest, Romania; (N.D.G.); (D.I.U.)
| | - Gabriela Stanciu
- Department of Chemistry and Chemical Engineering, Faculty of Applied Sciences and Engineering, Ovidius University of Constanța, 900527 Constanța, Romania
- Correspondence: (M.M.); (G.S.)
| | | | - Cristina Elena Dinu-Pîrvu
- Department of Physical and Colloidal Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy Carol Davila, 020956 Bucharest, Romania; (V.N.); (C.E.D.-P.)
| | - Eliza Oprea
- Department of Organic Chemistry, Biochemistry and Catalysis, Faculty of Chemistry, University of Bucharest, 030018 Bucharest, Romania;
| | - Manuela Ghica
- Department of Biostatistics, Faculty of Pharmacy, University of Medicine and Pharmacy Carol Davila, 020956 Bucharest, Romania;
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Shields AN, Taylor E, Welch JR. Understanding the conversation around COVID-19 and eating disorders: A thematic analysis of Reddit. J Eat Disord 2022; 10:8. [PMID: 35033210 PMCID: PMC8761051 DOI: 10.1186/s40337-022-00530-z] [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: 03/11/2021] [Accepted: 01/05/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Current research has found dramatic changes in the lives of those with eating disorders (EDs) during the COVID-19 pandemic. We build on existing research to investigate the long-term effects and adaptations that people with EDs have faced due to COVID-19 related changes. METHOD We collected 234 posts from three separate time periods from the subreddit r/EatingDisorders and analyzed them using thematic analysis. The posts were examined for initial patterns, and then those concepts were grouped into themes to reveal the authentic experiences of people living with EDs during the COVID-19 pandemic. RESULTS Initially, we found "lack of control" and "familial influences (loved ones seeking support)" emerge as themes within our broader data set throughout all three timeframes. There were additional themes that were present in only one or two of the collection periods. These themes consisted of "symptom stress," "technical stresses and concerns," and "silver linings." CONCLUSIONS Our analysis shows that people with EDs have fought significantly during the pandemic. Initially, the (lack of) control and routine in their lives has caused symptoms to become more challenging, while being forced to move back home also caused significant stress. However, concerns transformed as the pandemic progressed, resulting in new pressures causing people to exhibit novel ED symptoms or relapse altogether. Also notable is the relatively few COVID-specific posts as the pandemic progressed, suggesting that people have accepted COVID as their "new normal" and begun to build resilience to the challenges associated. These are vital factors for clinicians to consider as they begin taking existing and new patients, particularly as face-to-face treatment options become a possibility again. Existing research shows that the COVID-19 pandemic has transformed the lives of people who live with eating disorders in various ways. First, the pandemic has placed barriers on the path to recovery by limiting coping mechanism (and sometimes removing them altogether) and changing their relationships with food and the people in their lives. Second, the pandemic has forced treatment options to change since ED patients can no longer seek treatment face-to-face. Finally, there have been unexpected benefits to the pandemic, such as allowing individuals time to slow down and focus on their mental health. Previous studies examined individuals in clinical contexts rather than in their natural environments. We explored an online forum for people with eating disorders for the various themes that were discussed at three points over the period of March 2020-December 2020 and found that many people with EDs report worsening symptoms or relapse. However, we also noted that, compared to the beginning of the pandemic, people seemed to be less frequently asking for support during the third data collection period, implying an adaptation to the "new normal" of life in a pandemic. We conclude with a discussion of the findings.
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Linardon J, Messer M, Rodgers RF, Fuller‐Tyszkiewicz M. A systematic scoping review of research on COVID-19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field. Int J Eat Disord 2022; 55:3-38. [PMID: 34773665 PMCID: PMC8646470 DOI: 10.1002/eat.23640] [Citation(s) in RCA: 90] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Research investigating the effects of COVID-19 on eating disorders is growing rapidly. A comprehensive evaluation of this literature is needed to identify key findings and evidence gaps to better inform policy decisions related to the management of eating disorders during and after this crisis. We conducted a systematic scoping review synthesizing and appraising this literature. METHOD Empirical research on COVID-19 impacts on eating disorder severity, prevalence, and demand for treatment was searched. No sample restrictions were applied. Findings (n = 70 studies) were synthesized across six themes: (a) suspected eating disorder cases during COVID-19; (b) perceived pandemic impacts on symptoms; (c) symptom severity pre versus during the pandemic; (d) pandemic-related correlates of symptom severity; (e) impacts on carers/parents; and (f) treatment experiences during COVID-19. RESULTS Pandemic impacts on rates of probable eating disorders, symptom deterioration, and general mental health varied substantially. Symptom escalation and mental health worsening during-and due to-the pandemic were commonly reported, and those most susceptible included confirmed eating disorder cases, at-risk populations (young women, athletes, parent/carers), and individuals highly anxious or fearful of COVID-19. Evidence emerged for increased demand for specialist eating disorder services during the pandemic. The forced transition to online treatment was challenging for many, yet telehealth alternatives seemed feasible and effective. DISCUSSION Evidence for COVID-19 effects is mostly limited to participant self-report or retrospective recall, cross-sectional and descriptive studies, and samples of convenience. Several novel pathways for future research that aim to better understand, monitor, and support those negatively affected by the pandemic are formulated.
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Affiliation(s)
- Jake Linardon
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia,Center for Social and Early Emotional DevelopmentDeakin UniversityBurwoodVictoriaAustralia
| | - Mariel Messer
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
| | - Rachel F. Rodgers
- APPEAR, Department of Applied PsychologyNortheastern UniversityBostonMassachusettsUSA,Department of Psychiatric Emergency & Acute CareLapeyronie Hospital, CHRU MontpellierMontpellierFrance,Department of PsychologySapienza University of RomeRomeItaly
| | - Matthew Fuller‐Tyszkiewicz
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia,Center for Social and Early Emotional DevelopmentDeakin UniversityBurwoodVictoriaAustralia
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Baenas I, Etxandi M, Munguía L, Granero R, Mestre-Bach G, Sánchez I, Ortega E, Andreu A, Moize VL, Fernández-Real JM, Tinahones FJ, Diéguez C, Frühbeck G, Le Grange D, Tchanturia K, Karwautz A, Zeiler M, Imgart H, Zanko A, Favaro A, Claes L, Shekriladze I, Serrano-Troncoso E, Cecilia-Costa R, Rangil T, Loran-Meler ME, Soriano-Pacheco J, Carceller-Sindreu M, Navarrete R, Lozano M, Linares R, Gudiol C, Carratala J, Plana MT, Graell M, González-Parra D, Gómez-del Barrio JA, Sepúlveda AR, Sánchez-González J, Machado PPP, Håkansson A, Túry F, Pászthy B, Stein D, Papezová H, Gricova J, Bax B, Borisenkov MF, Popov SV, Gubin DG, Petrov IM, Isakova D, Mustafina SV, Kim YR, Nakazato M, Godart N, van Voren R, Ilnytska T, Chen J, Rowlands K, Voderholzer U, Monteleone AM, Treasure J, Jiménez-Murcia S, Fernández-Aranda F. Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study. Nutrients 2021; 14:nu14010100. [PMID: 35010974 PMCID: PMC8746935 DOI: 10.3390/nu14010100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/18/2022] Open
Abstract
Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients.
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Affiliation(s)
- Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
| | - Mikel Etxandi
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
| | - Lucero Munguía
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Department of Psychobiology and Methodology, School of Psychology, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, 26006 La Rioja, Spain;
| | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
| | - Emilio Ortega
- Endocrinology and Nutrition Division, Hospital Clinic and Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), 08036 Barcelona, Spain; (E.O.); (A.A.); (V.L.M.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Alba Andreu
- Endocrinology and Nutrition Division, Hospital Clinic and Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), 08036 Barcelona, Spain; (E.O.); (A.A.); (V.L.M.)
| | - Violeta L. Moize
- Endocrinology and Nutrition Division, Hospital Clinic and Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), 08036 Barcelona, Spain; (E.O.); (A.A.); (V.L.M.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Jose-Manuel Fernández-Real
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Unit of Diabetes, Endocrinology and Nutrition, Hospital de Girona Dr. Josep Trueta-Institut d’Investigació Biomèdica de Girona (IDIBGI), 17007 Girona, Spain
- Department of Medical Sciences, School of Medicine, University of Girona, 17004 Girona, Spain
| | - Francisco J. Tinahones
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital-Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
| | - Carlos Diéguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, 15782 Santiago de Compostela, Spain
| | - Gema Frühbeck
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Metabolic Research Laboratory, Clínica Universidad de Navarra, University of Navarra-IdiSNA, 31008 Pamplona, Spain
| | - Daniel Le Grange
- Eating Disorders Program, Department of Psychiatry, University of California, San Francisco, CA 94143, USA;
| | - Kate Tchanturia
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK; (K.T.); (K.R.); (J.T.)
| | - Andreas Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (A.K.); (M.Z.)
| | - Michael Zeiler
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (A.K.); (M.Z.)
| | - Hartmut Imgart
- Parkland Klinik, 34537 Bad Wildungen, Germany; (H.I.); (A.Z.)
| | - Annika Zanko
- Parkland Klinik, 34537 Bad Wildungen, Germany; (H.I.); (A.Z.)
| | - Angela Favaro
- Department of Neuroscience, University of Padua and Neuroscience Center (PNC), 35122 Padua, Italy;
| | - Laurence Claes
- Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium;
- Clinical Psychology, Faculty of Medicine and Health Sciences, University Antwerp, 2000 Antwerp, Belgium
| | - Ia Shekriladze
- D. Uznadze Institute of Psychology, Ilia State University, 0162 Tbilisi, Georgia;
| | - Eduardo Serrano-Troncoso
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu- Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain; (E.S.-T.); (R.C.-C.)
| | - Raquel Cecilia-Costa
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu- Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain; (E.S.-T.); (R.C.-C.)
| | - Teresa Rangil
- Department of Psychiatry, Germans Trias i Pujol University Hospital-IGTP, 08916 Barcelona, Spain; (T.R.); (M.E.L.-M.)
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Maria Eulalia Loran-Meler
- Department of Psychiatry, Germans Trias i Pujol University Hospital-IGTP, 08916 Barcelona, Spain; (T.R.); (M.E.L.-M.)
| | - José Soriano-Pacheco
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau-Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau)-Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain; (J.S.-P.); (M.C.-S.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; (M.T.P.); (M.G.); (J.A.G.-d.B.)
| | - Mar Carceller-Sindreu
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau-Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau)-Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain; (J.S.-P.); (M.C.-S.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; (M.T.P.); (M.G.); (J.A.G.-d.B.)
| | - Rosa Navarrete
- Centro de Diagnóstico de Enfermedades Moleculares, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
| | | | | | - Carlota Gudiol
- Infectious Diseases Department, Hospital Universitari Bellvitge-Institut de Investigació Biomedica de Bellvitge (IDIBELL)-Institut Català d’Oncologia-Hospitalet, 08908 Barcelona, Spain; (C.G.); (J.C.)
- REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jordi Carratala
- Infectious Diseases Department, Hospital Universitari Bellvitge-Institut de Investigació Biomedica de Bellvitge (IDIBELL)-Institut Català d’Oncologia-Hospitalet, 08908 Barcelona, Spain; (C.G.); (J.C.)
- REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Maria T. Plana
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; (M.T.P.); (M.G.); (J.A.G.-d.B.)
- Institute of Neuroscience, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, 08036 Barcelona, Spain
| | - Montserrat Graell
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; (M.T.P.); (M.G.); (J.A.G.-d.B.)
- Child and Adolescent Psychiatry and Psychology Service, Child Hospital Niño Jesus, 28009 Madrid, Spain
| | - David González-Parra
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC)-Institute of Biomedicine of Salamanca (IBSAL)-University of Salamanca, 37008 Salamanca, Spain;
| | - José A. Gómez-del Barrio
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; (M.T.P.); (M.G.); (J.A.G.-d.B.)
- Unidad de Trastornos de la Conducta Alimentaria, Hospital Universitario “Marqués de Valdecilla”, Avda, Valdecilla s/n, 39011 Santander, Spain
- Instituto de Investigación Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Ana R. Sepúlveda
- Facultad de Psicología, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
| | - Jéssica Sánchez-González
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
| | - Paulo P. P. Machado
- Psychotherapy and Psychopathology Research Unit—Psychology Research Center, School of Psychology, University of Minho, 4710-057 Braga, Portugal;
| | - Anders Håkansson
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 00 Lund, Sweden;
- Gambling Disorder Unit, Malmö Addiction Center, 205 02 Malmö, Sweden
| | - Ferenc Túry
- Institute of Behavioral Sciences, Semmelweis University, 1085 Budapest, Hungary;
| | - Bea Pászthy
- 1st Department of Paediatrics, Semmelweis University, 1085 Budapest, Hungary;
| | - Daniel Stein
- Safra Children’s Hospital, Chaim Sheba Medical Center, Tel Hashomer 52 621, Israel;
| | - Hana Papezová
- Department of Psychiatry, 1st Medical Faculty of Charles University, 11000 Prague, Czech Republic; (H.P.); (J.G.)
| | - Jana Gricova
- Department of Psychiatry, 1st Medical Faculty of Charles University, 11000 Prague, Czech Republic; (H.P.); (J.G.)
| | - Brigita Bax
- Eating Disorders Center, Vilnius University Vilnius, 01513 Vilnius, Lithuania;
| | - Mikhail F. Borisenkov
- Institute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences, 167982 Syktyvkar, Russia; (M.F.B.); (S.V.P.)
| | - Sergey V. Popov
- Institute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences, 167982 Syktyvkar, Russia; (M.F.B.); (S.V.P.)
| | - Denis G. Gubin
- Laboratory for Chronobiology and Chronomedicine, Department of Biology, Tyumen State Medical University, 625023 Tyumen, Russia;
- Tyumen Cardiology Research Institute, Tomsk Research Medical Center, 634009 Tyumen, Russia
| | - Ivan M. Petrov
- Department of Biological & Medical Physics UNESCO, Tyumen State Medical University, 625023 Tyumen, Russia;
| | - Dilara Isakova
- Department of Therapy and Endocrinology, Tyumen State Medical University, 625023 Tyumen, Russia;
| | - Svetlana V. Mustafina
- Institute of Internal and Preventive Medicine–Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia;
| | - Youl-Ri Kim
- Department of Psychiatry, Seoul Paik Hospital-Inje University, Seoul 01757, Korea;
| | - Michiko Nakazato
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Narita 286-8686, Japan;
| | - Nathalie Godart
- CESP, Université Paris-Saclay, UVSQ, INSERM U 1178, 94805 Villejuif, France;
- Department of Psychiatry, Institut Mutualiste Montsouris, School of Medicine, Université Paris Descartes, 75006 Paris, France
- UFR des Sciences de la Santé Simone Veil (UVSQ), Praticienne Hospitalière, Fondation Santé des Etudiants de France, 78180 Paris, France
| | - Robert van Voren
- Department of Political Science, Vytautas Magnus University, 44248 Kaunas, Lithuania;
| | - Tetiana Ilnytska
- Institute of Psychiatry of Taras Shevchenko, National University of Kyiv, 01033 Kyiv, Ukraine;
| | - Jue Chen
- Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 280, Shanghai 200030, China;
| | - Katie Rowlands
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK; (K.T.); (K.R.); (J.T.)
| | | | - Alessio M. Monteleone
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Universitá degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK; (K.T.); (K.R.); (J.T.)
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: (S.J.-M.); (F.F.-A.); Tel.: +34-93-260-7227 (S.J.-M. & F.F.-A.)
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: (S.J.-M.); (F.F.-A.); Tel.: +34-93-260-7227 (S.J.-M. & F.F.-A.)
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Albano G, Bonfanti RC, Gullo S, Salerno L, Lo Coco G. The psychological impact of COVID-19 on people suffering from dysfunctional eating behaviours: a linguistic analysis of the contents shared in an online community during the lockdown. RESEARCH IN PSYCHOTHERAPY (MILANO) 2021; 24:557. [PMID: 35047429 PMCID: PMC8715260 DOI: 10.4081/ripppo.2021.557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/08/2021] [Indexed: 12/15/2022]
Abstract
The coronavirus disease 2019 (COVID-19) spread several months ago from China and it is now a global pandemic. The experience of lockdown has been an undesirable condition for people with mental health problems, including eating disorders. The present study has the aim of understanding the impact of the first wave of the COVID-19 pandemic on people with selfreported disordered eating behaviours. A linguistic analysis was carried out with regard to the online posts and comments published by 1971 individuals (86% women) in a Facebook online community focusing on EDs during the lockdown. A total of 244 posts and 3603 comments were collected during the 56 days of lockdown (from the 10th of March until the 4th of May 2020) in Italy and were analysed by Linguistic Inquiry and Word Count (LIWC) software. The results showed that words related to peer support decreased in posts over time, and that anxiety and anger increased in the published comments. Moreover, greater feelings of negativity and anxiety were found in posts and comments throughout the COVID-19 pandemic, as well as lesser use of words related to positive emotions. Thematic qualitative analysis revealed eight themes that described the main subjective components of ED symptomatology and distress during the first COVID-19 lockdown. The current findings can help in delivering tailored treatments to people with eating disorders during the COVID-19 pandemic.
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Affiliation(s)
- Gaia Albano
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Rubinia Celeste Bonfanti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Salvatore Gullo
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Laura Salerno
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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Mannino G, Salerno L, Bonfanti RC, Albano G, Lo Coco G. The impact of Facebook use on self-reported eating disorders during the COVID-19 lockdown. BMC Psychiatry 2021; 21:611. [PMID: 34876064 PMCID: PMC8651245 DOI: 10.1186/s12888-021-03628-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The social isolation due to the COVID-19-related lockdown has had an impact on social media consumption around the world. This study examines the relationship between fear of COVID-19, Facebook use and disordered eating. METHODS Structural Equation Modeling was used to analyse two-wave survey data (T0: Italian first lockdown; T1: after two months) during the pandemic. Young adults with self-reported dysfunctional eating behaviors (N = 115; 91.3% females; mean age = 28.60 ± 7.31) were recruited to complete an online survey at T0; 66 participants (92.4% females; mean age = 28.85 ± 7.85) completed the survey at T1. They were assessed on Facebook use, dysfunctional eating cognitions, and fear of COVID-19. RESULTS Participants' disordered eating cognitions increased during the pandemic. At T0, higher fear of COVID-19 was positively associated to time spent on Facebook, which in turn predicted disordered eating cognitions at T1. Moreover, maladaptive Facebook use mediated the relationship between daily time on Facebook and Shape concerns. CONCLUSIONS The findings of this study suggest an influence of dysfunctional Facebook use in increasing disordered eating cognitions during the pandemic.
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Affiliation(s)
| | - Laura Salerno
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy.
| | - Rubinia Celeste Bonfanti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy
| | - Gaia Albano
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy
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Monteleone P. Eating Disorders in the Era of the COVID-19 Pandemic: What Have We Learned? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312381. [PMID: 34886107 PMCID: PMC8657195 DOI: 10.3390/ijerph182312381] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 01/23/2023]
Affiliation(s)
- Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081 Baronissi, Italy
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Sideli L, Lo Coco G, Bonfanti RC, Borsarini B, Fortunato L, Sechi C, Micali N. Effects of COVID-19 lockdown on eating disorders and obesity: A systematic review and meta-analysis. EUROPEAN EATING DISORDERS REVIEW 2021; 29:826-841. [PMID: 34460991 PMCID: PMC8652707 DOI: 10.1002/erv.2861] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to examine: the pooled prevalence of symptomatic behaviours and mental health deterioration amongst individuals with eating disorders (EDs) and obesity during the COVID-19 confinement. Moreover, we examined changes in EDs and distress before and during the confinement, and the association between psychosocial factors and EDs symptoms. METHOD A systematic search was carried out in biomedical databases from January 2020 to January 2021. Both cross-sectional and longitudinal studies that used quantitative measures of ED symptoms and psychological distress during and after the COVID-19 confinement were included. RESULTS A total of 26 studies met inclusion criteria (n = 3399, 85.7% female). The pooled prevalence of symptomatic deterioration in EDs was 65% (95% CI[48,81], k = 10). The pooled prevalence of increased weight in obesity was 52% (95% CI[25,78], k = 4). More than half of the participants experienced depression and anxiety. Moreover, at least 75% of the individuals with EDs reported shape and eating concerns, and increased thinking about exercising. However, the pooled analyses of longitudinal studies showed no significant differences from pre-pandemic levels to the first lockdown phase in Body Mass Index and ED symptoms, whereas only few studies suggested increased distress, particularly among individuals with anorexia nervosa. CONCLUSIONS The majority of individuals with EDs and obesity reported symptomatic worsening during the lockdown. However, further longitudinal studies are needed to identify vulnerable groups, as well as the long-term consequences of COVID-19.
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Affiliation(s)
- Lucia Sideli
- Department of Human ScienceLUMSA UniversityRomeItaly
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Rubinia Celeste Bonfanti
- Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Bianca Borsarini
- Department of PsychiatryFaculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - Lucia Fortunato
- Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Cristina Sechi
- Department of Pedagogy, Psychology, PhilosophyUniversity of CagliariCagliariItaly
| | - Nadia Micali
- Department of PsychiatryFaculty of MedicineUniversity of GenevaGenevaSwitzerland
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Zarei M, Rahimi K, Hassanzadeh K, Abdi M, Hosseini V, Fathi A, Kakaei K. From the environment to the cells: An overview on pivotal factors which affect spreading and infection in COVID-19 pandemic. ENVIRONMENTAL RESEARCH 2021; 201:111555. [PMID: 34197816 PMCID: PMC8236413 DOI: 10.1016/j.envres.2021.111555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/24/2021] [Accepted: 06/16/2021] [Indexed: 05/06/2023]
Abstract
Several factors ranging from environmental risks to the genetics of the virus and that of the hosts, affect the spread of COVID-19. The impact of physicochemical variables on virus vitality and spread should be taken into account in experimental and clinical studies. Another avenue to explore is the effect of diet and its interaction with the immune system on SARS-CoV-2 infection and mortality rate. Past year have witnessed extensive studies on virus and pathophysiology of the COVID-19 disease and the cellular mechanisms of virus spreading. However, our knowledge has not reached a level where we plan an efficient therapeutic approach to prevent the virus entry to the cells or decreasing the spreading and morbidity in severe cases of disease. The risk of infection directly correlates with the control of virus spreading via droplets and aerosol transmission, as well as patient immune system response. A key goal in virus restriction and transmission rate is to understand the physicochemical structure of aerosol and droplet formation, and the parameters that affect the droplet-borne and airborne in different environmental conditions. The lifetime of droplets on different surfaces is described based on the contact angle. Hereby, we recommend regular use of high-quality face masks in high temperature and low humidity conditions. However, in humid and cold weather conditions, wearing gloves and frequently hand washing, gain a higher priority. Additionally, social distancing rules should be respected in all aforementioned conditions. We will also discuss different routes of SARS-CoV-2 entry into the cells and how multiple genetic factors play a role in the spread of the virus. Given the role of environmental and nutritional factors, we discuss and recommend some strategies to prevent the disease and protect the population against COVID-19. Since an effective vaccine can prevent the transmission of communicable diseases and abolish pandemics, we added a brief review of candidate SARS-CoV-2 vaccines.
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Affiliation(s)
- Mohammad Zarei
- Department of Food Science and Technology, School of Industrial Technology, Faculty of Applied Sciences, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
| | - Karim Rahimi
- Department of Molecular Biology and Genetics, Gene Expression and Gene Medicine, Aarhus University, Aarhus, Denmark
| | - Kambiz Hassanzadeh
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome, 00161, Italy; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Mohammad Abdi
- Department of Clinical Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Vahedeh Hosseini
- Department of Molecular Medicine and Genetics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Fathi
- FUJIFILM Cellular Dynamics, Inc., Madison, WI, USA.
| | - Karim Kakaei
- Department of Chemistry, Faculty of Science, University of Maragheh, Maragheh, Iran.
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Monteleone AM. The impact of the COVID-19 pandemic on eating disorders: A paradigm for an emotional post-traumatic stress model of eating disorders. Eur Neuropsychopharmacol 2021; 51:84-86. [PMID: 34098516 PMCID: PMC8482526 DOI: 10.1016/j.euroneuro.2021.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/08/2021] [Accepted: 05/12/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Alessio Maria Monteleone
- Department of Psychiatry, University of Campania L. Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy.
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Naccache B, Mesquida L, Raynaud JP, Revet A. Smartphone application for adolescents with anorexia nervosa: an initial acceptability and user experience evaluation. BMC Psychiatry 2021; 21:467. [PMID: 34563166 PMCID: PMC8466747 DOI: 10.1186/s12888-021-03478-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Anorexia Nervosa (AN) is a key target for E-Health programs considering the many barriers hindering patients' access to care and the disorder's severity. Although these programs have become more common and effective, they often have low adherence, especially among youth. This can hinder their implementation and effectiveness in real-world settings. User experience partly overlaps with the acceptability field and may provide insight into factors affecting adherence and adoption of E-Health programs. This study aimed to explore early acceptability and user experience of a companion app prototype for adolescents with AN using user-centered design methods. METHODS We developed a prototype containing self-help material and emotions and behaviors evaluation and management features. Then we conducted a mixed evaluation combining semi structured focus group interviews and questionnaires in a clinician group and an AN patient group. We analyzed data using thematic analysis and descriptive statistics. RESULTS The app's overall appeal was adequate. The user experience questionnaire revealed the weakest dimensions, including novelty, dependability, and efficiency versus stimulation (i.e., ability to induce motivation to use the product) and perspicuity (i.e., easy to understand, to get familiar with). The qualitative data analysis revealed three central axes: acceptability, features, and use. We identified acceptability barriers and facilitators such as the importance of design and customization, especially for adolescents. Psychoeducation was a major feature for participants, as patients highlighted the difficulties they encountered when seeking disorders-related information. CONCLUSIONS This study shows the importance of including users in the different stages of an e-health intervention development, in order to identify their needs, general use and compliance patterns, to improve adherence and adoption of the program and its effectiveness.
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Affiliation(s)
- Benjamin Naccache
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Hôpital Purpan, Place du Dr Baylac, TSA 40031, 31059, Toulouse cedex 9, France.
| | - Laure Mesquida
- grid.414282.90000 0004 0639 4960Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, CHU de Toulouse, Hôpital Purpan, Place du Dr Baylac, TSA 40031, 31059 Toulouse cedex 9, France
| | - Jean-Philippe Raynaud
- grid.414282.90000 0004 0639 4960Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, CHU de Toulouse, Hôpital Purpan, Place du Dr Baylac, TSA 40031, 31059 Toulouse cedex 9, France ,grid.15781.3a0000 0001 0723 035XCERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Alexis Revet
- grid.414282.90000 0004 0639 4960Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, CHU de Toulouse, Hôpital Purpan, Place du Dr Baylac, TSA 40031, 31059 Toulouse cedex 9, France ,grid.15781.3a0000 0001 0723 035XCERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France ,grid.411175.70000 0001 1457 2980CIC 1436, Team PEPSS « Pharmacologie En Population cohorteS et biobanqueS », Toulouse University Hospital, Toulouse, France
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Affiliation(s)
- Sara J Hansen
- Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
| | - David B Menkes
- Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
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Hansen SJ, Stephan A, Menkes DB. The impact of COVID-19 on eating disorder referrals and admissions in Waikato, New Zealand. J Eat Disord 2021; 9:105. [PMID: 34454600 PMCID: PMC8397868 DOI: 10.1186/s40337-021-00462-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/18/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Several countries have reported increased demand for eating disorder services during the COVID-19 pandemic, particularly for adolescents. Within New Zealand, anecdotal and media reports suggest similar changes but are limited in scope and detail. We assessed eating disorder service demand in the Waikato district in relation to the COVID-19 pandemic. METHODS We retrospectively analysed records of eating disorder admissions and referrals for both children (< 18 years) and adults (≥ 18 years) during 2019 and 2020 in the Waikato, a mixed urban-rural province in northern New Zealand (population 435,000). We analysed medical admission and outpatient referral rates, and referral acuity, in relation to the COVID-19 pandemic using Welch's t- and chi-square tests. RESULTS 106 medical admissions met inclusion criteria (n = 37 in 2019; 69 in 2020). Admissions for eating disorders increased markedly following nationwide lockdown in March 2020 (RR = 1.7, p = 0.01), largely driven by increases in adult admissions (RR 2.0, p = 0.005). The proportion of 'new patient' admissions showed comparable increases for both children (RR = 2.0, p = 0.02) and adults (RR = 2.3, p = 0.03). Following lockdown, outpatient referrals increased in acuity (RR = 1.8, p = 0.047) and volume (RR = 1.6, p = 0.076) for children but not for adults. CONCLUSIONS Our study confirms a pandemic-related increase in demand for eating disorder services in the Waikato region of New Zealand, consistent with findings reported overseas. We observed contrasting increases in admissions for adults and outpatient referrals for children, exacerbating resource constraints for already stretched services and compromising provision of timely care. The COVID-19 pandemic has been linked to increased numbers and worsening severity of eating disorders in several settings. In New Zealand, similar trends have been noted anecdotally. We assessed clinical records to calculate rates of eating disorder-related hospital admissions and outpatient referrals during 2019 and 2020. We found significant increases in hospital admissions related to COVID-19, particularly for adults, and greater proportions of both children and adults having a first-ever eating disorder-related admission. In outpatient services, young people were referred more frequently during the pandemic and were more physically unwell when referred. These results indicate increased demand for eating disorder services as a result of the pandemic and complement findings reported overseas.
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Affiliation(s)
- Sara J Hansen
- University of Auckland, Waikato Clinical Campus, Private Bag 3200, Hamilton, New Zealand.
| | - Alice Stephan
- Waikato District Health Board, Hamilton, New Zealand
| | - David B Menkes
- University of Auckland, Waikato Clinical Campus, Private Bag 3200, Hamilton, New Zealand.,Waikato District Health Board, Hamilton, New Zealand
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45
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Parsons H, Murphy B, Malone D, Holme I. Review of Ireland's First Year of the COVID-19 Pandemic Impact on People Affected by Eating Disorders: 'Behind Every Screen There Was a Family Supporting a Person with an Eating Disorder'. J Clin Med 2021; 10:3385. [PMID: 34362170 PMCID: PMC8347427 DOI: 10.3390/jcm10153385] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 01/14/2023] Open
Abstract
Irish society went into one of the most stringent lockdowns in March 2020 due to the COVID-19 pandemic, and barring a few weeks, remains highly restricted at time of writing. This has produced a wide range of challenges for those affected by eating disorders, as well as treatment services and Bodywhys, The Eating Disorders Association of Ireland. Current research indicates that COVID-19 has impacted across three key areas-the experience of those with an eating disorder, the experience of service provision, and the impact on the family situation. Drawing on monitoring and evaluation data gathered by Bodywhys, this paper details the challenges faced by those affected by eating disorders in Ireland and how the organisation responded to these challenges, providing support in various forms to people with eating disorders and their families.
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Affiliation(s)
- Harriet Parsons
- Bodywhys, The Eating Disorders Association of Ireland, P.O. Box 105, Blackrock, Co Dublin, Ireland; (B.M.); (D.M.)
| | - Barry Murphy
- Bodywhys, The Eating Disorders Association of Ireland, P.O. Box 105, Blackrock, Co Dublin, Ireland; (B.M.); (D.M.)
| | - Deirbhile Malone
- Bodywhys, The Eating Disorders Association of Ireland, P.O. Box 105, Blackrock, Co Dublin, Ireland; (B.M.); (D.M.)
| | - Ingrid Holme
- School of Sociology, University College Dublin, Dublin, Ireland;
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Branley-Bell D, Talbot CV. "It is the only constant in what feels like a completely upside down and scary world": Living with an eating disorder during COVID-19 and the importance of perceived control for recovery and relapse. Appetite 2021; 167:105596. [PMID: 34252493 PMCID: PMC8423590 DOI: 10.1016/j.appet.2021.105596] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/18/2022]
Abstract
The COVID-19 pandemic has had a profound, negative impact on the lives and wellbeing of much of the population, and it can raise additional challenges for individuals with eating disorders (EDs). During early stages of the UK lockdown, individuals reported disruptions to many aspects of their lives, including reduced feelings of control and serious concerns over the impact of the pandemic on ED symptoms and/or recovery. This study applied a mixed methods online survey to collect responses from 58 individuals (age 16-65yrs) with lived experience of EDs. Data was collected across two time points (April 2020 and June 2020) to explore the ongoing impacts of the pandemic on this population. The results suggest that higher perceptions of general, external control may be associated with ED recovery. Quantitative results show that individuals who reported recovering from their ED since the first time point, also reported significant increases in perceived control (compared to individuals who had relapsed or whose ED status was unchanged). Thematic analysis generated two themes: ED behaviours as an 'auxiliary control mechanism', and loss of auxiliary control after lockdown. Individuals who experienced less perceived control reported a tendency to rely upon eating disorder behaviours as an auxiliary coping mechanism, i.e., diminished external control was directed inwards and replaced with controlling their own behaviour. The preliminary results suggest that perceived control may be a significant factor in ED recovery. Individuals with EDs may be at significant risk of detrimental impacts on their recovery and wellbeing because of the pandemic reducing peoples' sense of control. These preliminary findings highlight the need for further research in this area, including investigation around potential interventions based upon strengthening perceptions of control to promote ED recovery.
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Affiliation(s)
- Dawn Branley-Bell
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, England, UK.
| | - Catherine V Talbot
- Department of Psychology, Faculty of Science and Technology, Bournemouth University, England, UK
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Stewart C, Konstantellou A, Kassamali F, McLaughlin N, Cutinha D, Bryant-Waugh R, Simic M, Eisler I, Baudinet J. Is this the 'new normal'? A mixed method investigation of young person, parent and clinician experience of online eating disorder treatment during the COVID-19 pandemic. J Eat Disord 2021; 9:78. [PMID: 34193291 PMCID: PMC8243044 DOI: 10.1186/s40337-021-00429-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/09/2021] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Prior to the COVID-19 pandemic, research in virtual care for young people with eating disorders was preliminary and implementation rare. This study explored the experience of young people, parents and clinicians when therapy was transitioned to virtual provision as a result of the UK lockdown in March 2020. METHODS A mixed-method approach was used in this study. Online questionnaires that included a mixture of rating (Likert scale) and free-text response questions were completed by 53 young people with any eating disorder, 75 parents and 23 clinicians. Questions focused on the experience of online treatment as well as the impact on engagement, perceived treatment efficacy and preferences around treatment mode in the future. Likert scale questions were analysed using a summary approach. Free-text responses were analysed qualitatively using reflexive thematic analysis. RESULTS Responses to rating scale questions indicate satisfaction with treatment, good engagement and ability to manage technology. Young people who had transitioned care, rather than started care virtually in lockdown, rated therapy as less effective. However, individual accounts of experience were more varied. Reflexive thematic analysis of free-text responses identified key themes of 1) Making it work, 2) Home as a therapeutic space, and 3) Disrupted connection and 4) Into the future. CONCLUSIONS These results have implications for ongoing care during the pandemic and for future implementation of virtual care in the treatment of young people with eating disorders. Particular issues arising are the trade-off between accessibility and therapeutic engagement and depth and need for consideration of equal access to treatment in socially unequal societies.
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Affiliation(s)
- Catherine Stewart
- Maudsley Centre for Child and Adolescent Eating Disorders, Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE8 5AZ, UK
| | - Anna Konstantellou
- Maudsley Centre for Child and Adolescent Eating Disorders, Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE8 5AZ, UK
| | - Fatema Kassamali
- Maudsley Centre for Child and Adolescent Eating Disorders, Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE8 5AZ, UK
| | - Natalie McLaughlin
- Maudsley Centre for Child and Adolescent Eating Disorders, Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE8 5AZ, UK
| | - Darren Cutinha
- Maudsley Centre for Child and Adolescent Eating Disorders, Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE8 5AZ, UK
| | - Rachel Bryant-Waugh
- Maudsley Centre for Child and Adolescent Eating Disorders, Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE8 5AZ, UK
| | - Mima Simic
- Maudsley Centre for Child and Adolescent Eating Disorders, Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE8 5AZ, UK
| | - Ivan Eisler
- Maudsley Centre for Child and Adolescent Eating Disorders, Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE8 5AZ, UK
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Julian Baudinet
- Maudsley Centre for Child and Adolescent Eating Disorders, Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE8 5AZ, UK.
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
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Jordan AK, Barnhart WR, Studer-Perez EI, Kalantzis MA, Hamilton L, Musher-Eizenman DR. 'Quarantine 15': Pre-registered findings on stress and concern about weight gain before/during COVID-19 in relation to caregivers' eating pathology. Appetite 2021; 166:105580. [PMID: 34186158 DOI: 10.1016/j.appet.2021.105580] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/19/2021] [Accepted: 06/23/2021] [Indexed: 10/21/2022]
Abstract
The coronavirus disease (COVID-19) has dramatically altered daily activities including eating and physical activity behaviors, which in turn may be related to eating pathology. Those who care for children (henceforth caregivers) may face the brunt of these changes, but little research has examined the consequences of COVID-19 on eating pathology in caregivers. A community sample of caregivers (N = 140) completed a cross-sectional online survey assessing demographics, stress and concern about weight gain before/during COVID-19, disordered eating (Eating Disorder Examination Questionnaire-Short Form), and emotional eating (Emotional Eating Scale-Revised). Significant positive relationships emerged between stress and concern about weight gain before/during COVID-19 and disordered eating, emotional eating-depression, emotional eating-anger/anxiety, and emotional eating-boredom. Stress and concern about weight gain during, but not before, COVID-19 positively predicted variance in disordered eating and emotional eating. Stress was associated with lower emotional eating-boredom when concern about weight gain during COVID-19 was low. Stress was associated with lower emotional eating-depression when concern about weight gain before COVID-19 was low, but when high, stress was associated with higher emotional eating-depression. Stress and concern about weight gain before/during COVID-19 may be relevant to worsened disordered eating and emotional eating in caregivers, a neglected population in the literature. Targeting concern about weight gain may weaken the relationship between stress and emotional eating-depression and emotional eating-boredom among caregivers in the context of the COVID-19 pandemic.
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Affiliation(s)
- Amy K Jordan
- Department of Psychology, Bowling Green State University, USA.
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Buckley GL, Hall LE, Lassemillante ACM, Belski R. Disordered eating & body image of current and former athletes in a pandemic; a convergent mixed methods study - What can we learn from COVID-19 to support athletes through transitions? J Eat Disord 2021; 9:73. [PMID: 34167589 PMCID: PMC8223527 DOI: 10.1186/s40337-021-00427-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/08/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has seen worsened mental health as a result of lockdowns, isolation and changes to sociocultural functioning. The postponement of the Tokyo 2020 Olympics is representative of global cancellations of sporting events, reduced facility access and support restrictions that have affected both current and former athlete's psychological wellbeing. This study aimed to determine whether current (n = 93) and former (n = 111) athletes experienced worsened body image, relationship with food or eating disorder symptomatology during acute COVID-19 transitions. METHODS The study was a Convergent Mixed Methods design whereby qualitative content analysis was collected and analysed simultaneously with quantitative cross-sectional data using the EAT-26 and self-report COVID-19 questions. Data were collected from April until May 2020 to capture data pertaining to transitions related to the pandemic and included individuals across 41 different individual and team sports from club to international competition levels. RESULTS There was a surge in disordered eating in current and former athletes as a result of the early COVID-19 response. Eating disorders were suggested to occur in 21.1% of participants (18% current athletes n = 17, 25% former athletes (n = 26). There was a significant difference between males and females (p = 0.018, r = 0.17), but interestingly no differences between groups from individual vs team sports, type of sporting category (endurance, antigravitational, ball sport, power, technical and aesthetic) or level of competition (club, state, national or international). 34.8% (n = 69) self-reported worsened body image and 32.8% (n = 65) self-reported a worsened food relationship directly from COVID-19. Qualitative analysis indicated that disordered eating occurred predominantly in the form of body preoccupation, inhibitory food control, fear of body composition changes and binge eating. CONCLUSIONS This study indicates that transitions in COVID-19 have worsened food-body relationships in current and former athletes and must be treated as an at-risk time for eating disorder development. We suggest that resources are allocated appropriately to assist athletes to foster psychologically positive food and body relationships through COVID-19 transitions. This study makes practice suggestions in supporting athletes to manage control, seek support, adapt and accept change and promote connection and variety through athletic transitions.
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Affiliation(s)
- Georgina Louise Buckley
- Department of Nursing and Allied Health, Swinburne University of Technology, John St, Hawthorn, Victoria 3122 Australia
- Charles Perkins Centre, Inside Out Institute, Sydney University, John Hopkins Drive, Camperdown, New South Wales 2050 Australia
| | | | - Annie-Claude M. Lassemillante
- Department of Nursing and Allied Health, Swinburne University of Technology, John St, Hawthorn, Victoria 3122 Australia
| | - Regina Belski
- Department of Nursing and Allied Health, Swinburne University of Technology, John St, Hawthorn, Victoria 3122 Australia
- Department of Dietetics, Human Nutrition and Sport, LaTrobe University, Bundoora, Victoria 3083 Australia
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Czepczor-Bernat K, Swami V, Modrzejewska A, Modrzejewska J. COVID-19-Related Stress and Anxiety, Body Mass Index, Eating Disorder Symptomatology, and Body Image in Women from Poland: A Cluster Analysis Approach. Nutrients 2021; 13:1384. [PMID: 33924010 PMCID: PMC8073902 DOI: 10.3390/nu13041384] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 01/14/2023] Open
Abstract
To limit the spread of the novel coronavirus (COVID-19), many countries have introduced mandated lockdown or social distancing measures. Although these measures may be successful against COVID-19 transmission, the pandemic and attendant restrictions are a source of chronic and severe stress and anxiety which may contribute to the emergence or worsening of symptoms of eating disorders and the development of negative body image. Therefore, in this study, we aimed to: (1) classify different conditions associated with COVID-19-related stress, COVID-19-related anxiety, and weight status; and (2) analyze and compare the severity of dimensions typically related to eating disorders symptomatology and body image in individuals with different COVID-19-related stress, COVID-19-related anxiety, and weight status. Polish women (N = 671, Mage = 32.50 ± 11.38) completed measures of COVID-19-related stress and anxiety along with body dissatisfaction, drive for thinness, and bulimia symptomatology subscales of the Eating Disorders Inventory, and the appearance evaluation, overweight preoccupation, and body areas satisfaction subscales of the Multidimensional Body-Self Relations Questionnaire. The following four clusters were identified through cluster analysis: (a) Cluster 1 (N = 269), healthy body weight and low COVID-related stress (M = 3.06) and anxiety (M = 2.96); (b) Cluster 2 (N = 154), healthy body weight and high COVID-related stress (M = 5.43) and anxiety (M = 5.29); (c) Cluster 3 (N = 127), excess body weight and high COVID-related stress (M = 5.23) and anxiety (M = 5.35); (d) Cluster 4 (N = 121), excess body weight and low COVID-related stress (M = 2.69) and anxiety (M = 2.83). Our results showed that Clusters 3 and 4 had significantly greater body dissatisfaction and lower appearance evaluation and body areas satisfaction than Clusters 1 and 2. Cluster 3 also had a significantly higher level of drive for thinness, bulimia, and overweight preoccupation than Clusters 1 and 2. These preliminary findings may mean that the COVID-19 pandemic and attendant anxiety and stress caused by the pandemic are exacerbating symptoms of eating disorders and negative body image, with women with excess weight particularly at risk.
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Affiliation(s)
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK;
- Centre for Psychological Medicine, Perdana University, Changkat Semantan, Kuala Lumpur 50490, Malaysia
| | - Adriana Modrzejewska
- Department of Psychology, Katowice Business University, Harcerzy Września 1939 3, 40-659 Katowice, Poland;
| | - Justyna Modrzejewska
- Institute of Pedagogy, University of Bielsko-Biala, Willowa 2, 43-309 Bielsko-Biala, Poland;
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