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Bracké K, Steegers C, van der Harst T, Pons R, Legerstee J, Dierckx B, de Nijs P, Bax-van Berkel M, van Elburg A, Hekkelaan M, Hokke J, de Jong-Zuidema H, Korthals Altes L, Lengton-van der Spil F, Luijkx J, Schuurmans F, Smeets C, van Wijk L, Woltering C, Vernooij M, Hillegers M, White T, Dieleman G. The implications of the COVID-19 pandemic on eating disorder features and comorbid psychopathology among adolescents with anorexia nervosa and matched controls: a comparative cohort design study. Eat Weight Disord 2024; 29:13. [PMID: 38347293 PMCID: PMC10861646 DOI: 10.1007/s40519-024-01640-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/28/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE To examine implications of the COVID-19 pandemic on eating disorder (ED) features and psychopathology in female adolescents with anorexia nervosa (AN). METHOD In total 79 females with first-onset AN (aged 12-22 years) were included and were followed up across a period of 1 year. We assessed AN participants recruited pre-pandemic (n = 49) to those recruited peri-pandemic (n = 30). Pre- (n = 37) and peri-pandemic (n = 38) age-, and education-matched typically developing (TD) girls (n = 75) were used as a reference cohort. ED features and psychopathology were assessed at baseline. After 1 year of follow-up the association between pandemic timing and clinical course was assessed. Analyses of covariance were used to examine differences in ED features and psychopathology. RESULTS Peri-pandemic AN participants experienced less ED symptoms at baseline compared to pre-pandemic AN participants. In particular, they were less dissatisfied with their body shape, and experienced less interpersonal insecurity. In addition, the peri-pandemic AN group met fewer DSM-IV criteria for comorbid disorders, especially anxiety disorders. In contrast, peri-pandemic AN participants had a smaller BMI increase over time. In TD girls, there were no differences at baseline in ED features and psychopathology between the pre- and peri-pandemic group. CONCLUSION Overall, peri-pandemic AN participants were less severely ill, compared to pre-pandemic AN participants, which may be explained by less social pressure and peer contact, and a more protective parenting style during the pandemic. Conversely, peri-pandemic AN participants had a less favorable clinical course, which may be explained by reduced access to health care facilities during the pandemic. LEVEL OF EVIDENCE Level III: Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Katrien Bracké
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Cathelijne Steegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Tess van der Harst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Rozemarijn Pons
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Jeroen Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Bram Dierckx
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Pieter de Nijs
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | | | - Annemarie van Elburg
- Altrecht-Rintveld, Mental Health Care Organisation for Eating Disorders, Zeist, The Netherlands
| | - Marion Hekkelaan
- Department of Pediatrics, Het Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Joke Hokke
- Emergis-Ithaka, Mental Health Care Organisation for Child and Adolescent Psychiatry, Kloetinge, The Netherlands
| | - Hetty de Jong-Zuidema
- GGZ Delfland, Mental Health Care Organisation for Child and Adolescent Psychiatry, Delft, The Netherlands
| | - Lucas Korthals Altes
- LUMC-Curium, Mental Health Care Organisation for Child and Adolescent Psychiatry, Leiden, The Netherlands
| | - Farida Lengton-van der Spil
- Department for Eating Disorders, Emergis, Organisation for Mental Health and Well-Being, Goes, The Netherlands
| | - Judith Luijkx
- GGZ Westelijk Noord Brabant, Mental Health Care Organisation for Child and Adolescent Psychiatry, Roosendaal and Bergen Op Zoom, Bergen Op Zoom, The Netherlands
| | - Femke Schuurmans
- Department of Pediatrics, The Bravis Hospital, Bergen Op Zoom, The Netherlands
| | - Carien Smeets
- Department of Pediatrics, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Lia van Wijk
- Department of Pediatrics, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands
| | - Claire Woltering
- Department of Pediatrics, Het Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Meike Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Section on Social and Cognitive Developmental Neuroscience, National Institutes of Mental Health, Bethesda, MD, USA
| | - Gwen Dieleman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands.
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Boogaard R, Smit F, Schornagel R, Vaessen-Verberne AAPH, Kouwenberg JM, Hekkelaan M, Hendriks T, Feith SWW, Hop WCJ, de Jongste JC, Merkus PJFM. Recombinant human deoxyribonuclease for the treatment of acute asthma in children. Thorax 2007; 63:141-6. [PMID: 17675321 DOI: 10.1136/thx.2007.081703] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Airway obstruction in acute asthma is the result of airway smooth muscle contraction, inflammation and mucus plugging. Case reports suggest that mucolytic therapy might be beneficial in acute asthma. The aim of this study was to determine the efficacy of the mucolytic drug recombinant human deoxyribonuclease (rhDNase) in addition to standard treatment at the emergency department in children with an asthma exacerbation. METHODS In a multicentre randomised double-blind controlled clinical trial, 121 children brought to the emergency room for a moderate to severe asthma exacerbation were randomly assigned to receive either a single dose of 5 mg nebulised rhDNase or placebo following the second dose of bronchodilators. An asthma score (scale 5-15) was assessed at baseline and at 1, 2, 6, 12 and 24 h. The primary outcome variable was the asthma score 1 h after the study medication. RESULTS One hour after the study medication the asthma score in the rhDNase group showed an adjusted mean decrease from baseline of 1.0 (95% CI 0.5 to 1.6) points compared with 0.7 (95% CI 0.3 to 1.2) points in the placebo group (mean difference 0.4 (95% CI -0.2 to 1.0) points; p = 0.23). The asthma score over the study period of 24 h also did not differ significantly between the rhDNase and placebo group (mean difference 0.2 (95% CI -0.3 to 0.7) points, p = 0.40). The duration of oxygen supplementation and number of bronchodilator treatments in the first 24 h were similar in both groups. CONCLUSION Adding a single dose of nebulised rhDNase to standard treatment in the emergency room has no beneficial effects in children with moderate to severe acute asthma.
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Affiliation(s)
- R Boogaard
- Department of Pediatric Pulmonology, Erasmus MC-Sophia Children's Hospital, Rotterdam, P O Box 2060, 3000 CB Rotterdam, The Netherlands.
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