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Del Pozo G, Ezan P, Moubassat M, Déchelotte P. Does so-called "healthy" content on instagram display balanced recipes? A pilot study in relation to the risk of unhealthy eating patterns in social network users. Appetite 2024; 200:107542. [PMID: 38844048 DOI: 10.1016/j.appet.2024.107542] [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: 02/02/2024] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE social networks (SN) including Instagram have increased in popularity. However, SN-mediated content may influence eating behaviors in a negative way. This study analyzed whether Instagram content claimed as "healthy" complies with nutritional guidelines. METHODS recipes posted in French on Instagram with the caption #healthy or similar ones were analyzed, once from February to May 2023 and again in April 2024. Health authorities' guidelines and food pyramid inclusion criteria were used for the quantitative and qualitative analysis, respectively. Recipes were then classified as balanced, partially unbalanced or unbalanced, with the two subgroups "restrictive" and "excessive", and according to the main protein source. RESULTS we coded a total of 114 courses (2 datasets of 57 courses each). Among these, 3 were classified as balanced main courses, 45 as partially unbalanced main courses and 66 as unbalanced main courses (21 were deemed as restrictive, 21 as excessive and 24 were otherwise inadequate), with a majority of hypocaloric courses. Approximately half of the recipes were vegetarian or vegan. DISCUSSION these results suggest that food recipes published on Instagram as #healthy may, at times, be far from nutritional guidelines and could rather promote unbalanced eating patterns. This suggest that food-related content on SN might be insufficiently moderated and that recipes referenced as #healthy should perhaps be accompanied by warnings and preventive measures. This observation, in addition to other detrimental behaviors displayed on SN (e.g. extreme physical activity or body image pressure) may contribute to the increased incidence of eating disorders (ED) associated with problematic SN use. Alerts on this risk and accessible tools for the prevention and early detection of ED risk in SN users are urgently needed.
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Affiliation(s)
- Gina Del Pozo
- Nutrition Department and UMR INSERM 1073, Nutrition, Inflammation and Microbiota-Gut-Brain Axis - UMR 1073, 22 Boulevard Gambetta, 76000, Rouen, France.
| | - Pascale Ezan
- (NIMEC - University Le Havre Normandie), Université Le Havre Normandie PRSH 25, Rue Philippe Lebon BP 1123, 76063, Le Havre cedex, France.
| | - Marilyn Moubassat
- Nutrition Department and UMR INSERM 1073, Nutrition, Inflammation and Microbiota-Gut-Brain Axis - UMR 1073, 22 Boulevard Gambetta, 76000, Rouen, France.
| | - Pierre Déchelotte
- Nutrition Department and UMR INSERM 1073, Nutrition, Inflammation and Microbiota-Gut-Brain Axis - UMR 1073, 22 Boulevard Gambetta, 76000, Rouen, France.
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2
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Vavassori M, Donzelli G. Impact of COVID-19 restrictive measures during lockdown period on eating disorders: An umbrella review. Nutrition 2024; 124:112463. [PMID: 38749229 DOI: 10.1016/j.nut.2024.112463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 06/17/2024]
Abstract
The COVID-19 pandemic has sparked or amplified many mental health problems. The aim of this study was to compile evidence from existing systematic reviews to provide an overall assessment of the impact of social restrictions during the COVID-19 pandemic on people affected by eating disorders (EDs). PubMed and Scopus were searched up to August 16, 2023. Systematic reviews and meta-analyses were selected using the PRISMA 2020 statement. The quality assessment of the included studies was conducted using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Eleven studies were included in this umbrella review. Six main categories emerged from the studies described in the review: dietary changes and psychopathological effects showed an overall worsening of symptomatology; in studies concerning the impact of isolation and restrictive measures, it was found that social distancing was associated with feelings of loneliness, anxiety, and depression; limited access to direct care was found and therapeutic changes were made; the influence of mass media negatively impacted people with ED; several studies reported positive findings regarding symptomatology; finally, studies regarding 'impact on vulnerable populations showed that vulnerable people are more at risk of reporting body image distortion and eating disorders. The COVID-19 pandemic has negatively impacted most of the population with ED leading to a worsening of specific symptomatology. In addition, this worsening of the condition may be caused by limited access to care and treatment, changes in routine, or to the negative influence of the media.
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Affiliation(s)
| | - Gabriele Donzelli
- Department of Pharmacy, University of Pisa, Pisa, Italy; Institute of Clinical Physiology of the National Research Council (CNR-IFC), Pisa, Italy
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3
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Tam FI, Ochmann R, Marschall J, Leschzinski H, Seidel M, Klink L, Föcker M, Bühren K, Dahmen B, Jaite C, Herpertz-Dahlmann B, Seitz J, Gilsbach S, Correll CU, Müller AE, Hebebrand J, Bell R, Legenbauer T, Holtmann M, Becker K, Weber L, Romanos M, Egberts K, Kaess M, Fleischhaker C, Möhler E, Wessing I, Hagmann D, Hahn F, Thiemann U, Antony G, Gramatke K, Roessner V, Ehrlich S. The impact of the COVID-19 pandemic on administrative eating disorder prevalence in the outpatient sector and on severity of anorexia nervosa. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02527-2. [PMID: 39033259 DOI: 10.1007/s00787-024-02527-2] [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: 11/16/2023] [Accepted: 07/05/2024] [Indexed: 07/23/2024]
Abstract
The COVID-19 pandemic appears to have had a considerable impact on the mental health of children and adolescents, particularly regarding eating disorders. However, it remains unclear whether the pandemic affected only the frequency or also the severity of eating disorders. We examined potential pandemic-related changes in the administrative prevalence of eating disorders in the outpatient sector compared with other mental disorders using German statutory health insurance data for the age group 10 to 16 years. We also examined disorder severity of anorexia nervosa using data from the multicenter German Registry of Children and Adolescents with Anorexia Nervosa in the same age group. Our results showed a marked increase in the administrative prevalence of eating disorders (based on documented diagnoses) in the outpatient sector among girls but not among boys. A similar pattern was found for internalizing disorders, whereas the administrative prevalences of externalizing disorders decreased. Regarding the severity of anorexia nervosa among inpatients, we found no pandemic-related changes in body mass index standard deviation score at admission, body weight loss before admission, psychiatric comorbidities and psychopharmacological medication. Given the administrative prevalence increase in the outpatient sector, the lack of impact of the pandemic on the inpatient sector may also be partly due to a shift in healthcare utilization towards outpatient services during the pandemic. Thus, the higher number of children and adolescents requiring specialized and timely outpatient care may be a major concern under pandemic conditions.
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Affiliation(s)
- Friederike I Tam
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307, Fetscherstraße 74, Dresden, Germany.
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | | | | | - Henri Leschzinski
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307, Fetscherstraße 74, Dresden, Germany
| | - Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307, Fetscherstraße 74, Dresden, Germany
| | - Linda Klink
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307, Fetscherstraße 74, Dresden, Germany
| | - Manuel Föcker
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Katharina Bühren
- kbo-Heckscher-Klinikum, Academic Teaching Hospital of the LMU University, Munich, Germany
| | - Brigitte Dahmen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Hildesheim, Hildesheim, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Susanne Gilsbach
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany
| | - Antonia E Müller
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen (AöR), University of Duisburg-Essen, Essen, Germany
| | - Rebecca Bell
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen (AöR), University of Duisburg-Essen, Essen, Germany
| | - Tanja Legenbauer
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany
| | - Martin Holtmann
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Marburg & University Hospital Marburg (UKGM), Marburg, Germany
| | - Linda Weber
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Marburg & University Hospital Marburg (UKGM), Marburg, Germany
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Karin Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christian Fleischhaker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Freiburg, Freiburg, Germany
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Saarland University, Homburg, Germany
| | - Ida Wessing
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Daniela Hagmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Freia Hahn
- Department of Child & Adolescent Psychiatry and Psychotherapy, LVR Hospital Viersen, Viersen, Germany
| | - Ulf Thiemann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR Hospital Bonn, Bonn, Germany
| | - Gisela Antony
- Central Information Office, CIO Marburg GmbH, Fronhausen, Germany
| | - Katrin Gramatke
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307, Fetscherstraße 74, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Greenmyer JR. "Follow the Science" in COVID-19 Policy: A Scoping Review. HEC Forum 2024:10.1007/s10730-024-09521-w. [PMID: 38472729 DOI: 10.1007/s10730-024-09521-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 03/14/2024]
Abstract
"Follow the science" was commonly repeated during debates on COVID-19-related policy. The phrase "follow the science" raises questions that are central to our theories of knowledge and the application of scientific knowledge to maximize the wellbeing of our society. The purpose of this study was to (1) perform a scoping review of literature discussing "follow the science" and COVID-19, and (2) consider "follow the science" in the context of pediatric health. A comprehensive search of 14 databases was performed on May 23, 2023. Articles were included if they used terms such as "follow the science", "follow the scientists", "listen to science" or "listen to scientists", and discussed COVID-19. There were 24 articles included in the final review. Existing literature on "follow the science" (1) differentiates between scientific knowledge and policy decisions; (2) emphasizes the importance of social sciences in policy making; (3) calls for more transparency in the knowledge synthesis and policy generating process; and (4) finds that scientific advisors see their role as advising on science rather than policy decision making. There was no definitional, epistemological, or philosophical intellectual defense of "follow the science" in the peer reviewed literature. Policy requires (1) reliable data and (2) agreement on what to do considering those empirical facts by appealing to values, ethics, morality, and law. A review of school shutdowns is used as an example of the inadequacy of "follow the science" as a guiding principle for public policy.
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Affiliation(s)
- Jacob R Greenmyer
- Pediatric Hematology and Oncology, Hospice and Palliative Medicine, Mayo Clinic, 200 1st St NW, Rochester, MN, 55905, USA.
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5
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Madigan S, Vaillancourt T, Dimitropoulos G, Premji S, Kahlert SM, Zumwalt K, Korczak DJ, von Ranson KM, Pador P, Ganshorn H, Neville RD. A Systematic Review and Meta-Analysis: Child and Adolescent Healthcare Utilization for Eating Disorders During the COVID-19 Pandemic. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00077-7. [PMID: 38431196 DOI: 10.1016/j.jaac.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/30/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To conduct a meta-analysis documenting healthcare service utilization rates for pediatric (age <19 years) eating disorders during compared to before the COVID-19 pandemic. METHOD PsycINFO, MEDLINE, Embase, and Web of Science Core Collection were searched for studies published up to May 19, 2023. Studies with pediatric visits to primary care, inpatient, outpatient, and emergency department for eating disorders before and during the pandemic were included. This preregistered review (PROSPERO CRD42023413392) was reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were analyzed with random-effects meta-analyses. RESULTS A total of 52 studies reporting >148,000 child and adolescent eating disorder-related visits to >300 health settings across 15 countries were included (mean age, 12.7 years; SD = 4.1 years; 87% girls). There was strong evidence of an increase in healthcare use for eating disorders during the pandemic (rate ratio [RR] = 1.54, 95% CI = 1.38-1.71). Moderator analysis revealed larger rate increases among girls (RR = 1.48, 95% CI = 1.28-1.71) compared to boys (RR = 1.24, 95% CI = 1.06-1.45) and for adolescents (age ≥12 to 19 years) (RR = 1.53, 95% CI = 1.29-1.81) compared to children (RR = 0.87, 95% CI = 0.53-1.43). Moderator analysis demonstrated strong evidence of increased use of emergency department (RR = 1.70, 95% CI = 1.48-1.97), inpatient (RR = 1.56, 95% CI = 1.33-1.84), and outpatient (RR = 1.62, 95% CI = 1.35-1.95) services, as well as strong evidence of increased rates of anorexia nervosa (RR = 1.48, 95% CI = 1.24-1.75). CONCLUSION Healthcare use for pediatric eating disorders increased substantially during the COVID-19 pandemic, particularly among girls and adolescents. It is important to continue to monitor whether changes in healthcare use associated with acute pediatric mental distress are sustained beyond the COVID-19 pandemic. STUDY PREREGISTRATION INFORMATION Risk factors for eating disorders for youth during the COVID-19 pandemic; https://www.crd.york.ac.uk/; CRD42023413392. DIVERSITY & INCLUSION STATEMENT One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science.
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Affiliation(s)
- Sheri Madigan
- University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
| | | | - Gina Dimitropoulos
- University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | | | | | | | - Daphne J Korczak
- Hospital for Sick Children, Toronto, Canada; and the University of Toronto, Toronto, Canada
| | - Kristin M von Ranson
- University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
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6
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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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7
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Meneguzzo P, Di Pascoli L, Bindolo MC, Collantoni E, Meregalli V, Zanetti T, Veronese A, Tenconi E, Favaro A. The Psychological and Medical Landscape of Anorexia Nervosa over a Decade: A Retrospective Study of Possible Physical and Psychological Shifts. J Clin Med 2023; 12:7294. [PMID: 38068346 PMCID: PMC10707422 DOI: 10.3390/jcm12237294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 02/16/2024] Open
Abstract
In recent years, the definition, clinical characteristics, and psychological aspects of anorexia nervosa (AN) have undergone notable changes, influenced by various factors such as biology, psychology, and the environment. The COVID-19 pandemic is one such external factor that has been preliminarily identified as affecting the clinical presentation of AN. This study specifically aims to assess the alterations in psychological and medical features observed in individuals with AN during the pandemic. This study is a retrospective case review of 252 people diagnosed with AN from two different cohorts: 2010-2012 and 2021. A comparison of psychological and medical data was conducted to identify specific differences in the initial clinical evaluation. Additionally, different effects of the pandemic on age cohorts were assessed, with a focus on distinctions between adolescents and adults. Results revealed that the pandemic cohort had a higher number of new cases, with patients being younger and experiencing more severe psychological symptoms. Hospitalization rates upon first access were also elevated, but no significant differences in medical values were observed. Adolescents during the pandemic showed increased episodes of binge eating, decreased obsessive-compulsive symptoms, and greater difficulty in interoceptive awareness. This study reveals distinct differences in symptomatology among patients, with a particular focus on psychological characteristics such as impulsive behaviors and interoceptive awareness. These behavioral and interoceptive changes could have potential considerations in the treatment pathway. Further investigations are warranted to gain a deeper understanding of the evolving clinical presentation of anorexia nervosa after the pandemic.
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Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, 35122 Padova, Italy; (E.C.); (V.M.); (E.T.); (A.F.)
- Padova Neuroscience Center, University of Padova, 35122 Padova, Italy
| | - Lorenza Di Pascoli
- Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine, Padova University Hospital, 35128 Padova, Italy
- Eating Disorders Unit, Padova University Hospital, 35128 Padova, Italy
| | - Maria Cristina Bindolo
- Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine, Padova University Hospital, 35128 Padova, Italy
| | - Enrico Collantoni
- Department of Neuroscience, University of Padova, 35122 Padova, Italy; (E.C.); (V.M.); (E.T.); (A.F.)
- Padova Neuroscience Center, University of Padova, 35122 Padova, Italy
| | - Valentina Meregalli
- Department of Neuroscience, University of Padova, 35122 Padova, Italy; (E.C.); (V.M.); (E.T.); (A.F.)
- Padova Neuroscience Center, University of Padova, 35122 Padova, Italy
| | - Tatiana Zanetti
- Eating Disorders Unit, Padova University Hospital, 35128 Padova, Italy
| | - Angela Veronese
- Eating Disorders Unit, Padova University Hospital, 35128 Padova, Italy
| | - Elena Tenconi
- Department of Neuroscience, University of Padova, 35122 Padova, Italy; (E.C.); (V.M.); (E.T.); (A.F.)
- Padova Neuroscience Center, University of Padova, 35122 Padova, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, 35122 Padova, Italy; (E.C.); (V.M.); (E.T.); (A.F.)
- Padova Neuroscience Center, University of Padova, 35122 Padova, Italy
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8
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Schlapfer L, Gettis MA, Dutreuil V, Cherven B. Hospitalization patterns for adolescents with eating disorders during COVID-19. J Eat Disord 2023; 11:137. [PMID: 37587528 PMCID: PMC10433551 DOI: 10.1186/s40337-023-00867-z] [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: 06/09/2023] [Accepted: 08/09/2023] [Indexed: 08/18/2023] Open
Abstract
PURPOSE The purpose of this study was to examine differences in clinical characteristics and hospital length of stay (LOS) for adolescents with eating disorders (EDs) requiring medical stabilization during the pre-COVID-19 and COVID-19 time periods. METHODS Medical record data were abstracted for patients with EDs hospitalized for medical stabilization between 1/1/2019-2/29/2020 (pre-COVID-19) and 3/1/2020-12/31/2021 (during COVID-19). Patient demographics, clinical characteristics and LOS were compared between COVID-19 eras. Patients were categorized as boarding if they remained hospitalized ≥ 1 day after medical stabilization. Multivariate negative binomial linear regression models were performed to determine incidence rate ratios (IRR) and 95% confidence intervals (95% CI) for factors related to increased LOS. RESULTS Of the 467 admissions during this study, 120 were pre-COVID-19 and 347 were during COVID-19. Monthly admissions for EDs were higher during COVID-19 versus pre-COVID-19 (15.8 vs. 8.6, p = 0.001). On multivariate analysis, factors associated with increased LOS included admission during COVID-19 (IRR 1.27, 95% CI 1.15-1.40), p = 0.001), boarding (IRR 1.77, 95% CI 1.63-1.93, p = 0.001), public insurance (IRR 1.12, 95% CI 1.01-1.23, p = 0.032), nasogastric tube usage (IRR 1.62, 95% CI 1.48-1.76, p = 0.001), heart rate < 40 beats per minute (IRR 1.21, 95% CI 1.11-1.33, p = 0.001) and abnormal electrocardiogram (IRR 1.25, 95% CI 1.14-1.37, p = 0.001). CONCLUSION In addition to clinical factors, we found that admission during COVID-19, boarding, and public insurance were associated with increased LOS among patients with EDs. There is a need for greater availability of ED treatment centers to care for patients with EDs after medical stabilization.
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Affiliation(s)
- Leslie Schlapfer
- Children’s Healthcare of Atlanta, 1001 Johnson Ferry Rd NE, Atlanta, GA USA
| | - Margaret A. Gettis
- Children’s Healthcare of Atlanta, 1001 Johnson Ferry Rd NE, Atlanta, GA USA
| | - Valerie Dutreuil
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA USA
| | - Brooke Cherven
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA USA
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Özbaran NB, Yılancıoğlu HY, Tokmak SH, Yuluğ Taş B, Çek D, Bildik T. Changes in the psychosocial and clinical profiles of anorexia nervosa patients during the pandemic. Front Psychiatry 2023; 14:1207526. [PMID: 37539323 PMCID: PMC10394556 DOI: 10.3389/fpsyt.2023.1207526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/27/2023] [Indexed: 08/05/2023] Open
Abstract
The COVID-19 pandemic and related control measures have increased the prevalence of anorexia nervosa (AN), and recent studies demonstrated that approximately 70% of individuals diagnosed with AN experienced deterioration in symptoms. This study aimed to examine the psychosocial and clinical impacts on patients with AN during the COVID-19 pandemic. This cross-sectional study involved 35 female AN adolescents who were being treated at Ege University Child and Adolescent Psychiatry Department. To assess pre-pandemic symptom levels and daily life routines, a retrospective form utilizing the visual analog scale (VAS) was employed. Body mass index (BMI) and Clinical Global Impression (CGI) data were recorded by an interviewer for all 35 patients who gave consent to participate in the study. Fifteen patients completed all the forms [VAS, the Children's Depression Inventory (CDI), the Screen for Child Anxiety Related Disorders Scale (SCARED), the Eating Attitudes Test, the Quality-of-Life Scale (QoLS), the Autism Spectrum Screening Questionnaire, and the Turgay DSM-4 Based Screening and Evaluation Scale for Behavioral Disorders in Children and Adolescents] online in 2022. Clinical diagnosis and progress were assessed retrospectively using The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). The duration of the follow-up period and the number of psychiatric visits were obtained retrospectively from patient files. Retrospective data on pre-pandemic symptom levels and daily life routines were collected using the VAS. The mean age of AN patients was 16.67 ± 1.63 years. Comorbid diseases were present in 73.33% of patients, and major depressive disorder (MDD) was the most common (46.66%). Mean scores indicated moderate levels of anxiety (SCARED score: 37.23 ± 12.67) and depression (CDI score: 17.23 ± 10.85). QoLS scores were negatively correlated with eating attitudes (r = -0.601, p = 0.039). Obsession level, exercise level, and screen time increased during the pandemic, while social activity, quality of education, and perception of learning decreased. BMI increased in all patients. Patients who completed the forms had a higher number of psychiatric visits compared to those who did not complete the forms (p = 0.033). The mean number of clinic visits was 26.27 ± 20.33. The results show that the COVID-19 pandemic had adverse effects on AN patients and disrupted their daily routines. These patients experienced high rates of comorbidities. The patients showed improvement in BMI scores, indicating the positive impact of treatment. These findings emphasize the need for comprehensive psychiatric care and targeted interventions for AN patients during crises such as the COVID-19 pandemic.
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Affiliation(s)
- N. Burcu Özbaran
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ege University, İzmir, Türkiye
| | | | - Sibel Helin Tokmak
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ege University, İzmir, Türkiye
| | - Begüm Yuluğ Taş
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ege University, İzmir, Türkiye
| | - Didem Çek
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ege University, İzmir, Türkiye
| | - Tezan Bildik
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ege University, İzmir, Türkiye
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Stevenson RJ, Hill BJ, Hughes A, Wright M, Bartlett J, Saluja S, Francis HM. Interoceptive hunger, eating attitudes and beliefs. Front Psychol 2023; 14:1148413. [PMID: 37151322 PMCID: PMC10160651 DOI: 10.3389/fpsyg.2023.1148413] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Interoceptive individual differences have garnered interest because of their relationship with mental health. One type of individual difference that has received little attention is variability in the sensation/s that are understood to mean a particular interoceptive state, something that may be especially relevant for hunger. We examined if interoceptive hunger is multidimensional and idiosyncratic, if it is reliable, and if it is linked to dysfunctional eating and beliefs about the causes of hunger. Participants completed a survey just before a main meal, with most retested around 1 month later. We found that interoceptive hunger has 11 dimensions, and while people differ considerably in their combinations of interoceptive hungers, these represent only 4% of all possible permutations. Hunger reports were reliable. We found relationships between variability in hunger interoception and dysfunctional eating, especially for uncontrolled eating. We also found that hunger beliefs were in some cases strongly related to aspects of hunger interoception. The implications of these findings are discussed.
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