Wendy Spettigue1, Nicole Obeid2, Madison Erbach2, Stephen Feder3, Natalie Finner3, Megan E Harrison3, Leanna Isserlin4, Amy Robinson3, Mark L Norris3. 1. Department of Psychiatry, Children's Hospital of Eastern Ontario, Ottawa, Canada. wspettigue@cheo.on.ca. 2. Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Canada. 3. Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada. 4. Department of Psychiatry, Children's Hospital of Eastern Ontario, Ottawa, Canada.
Abstract
BACKGROUND: There is a noticeable lack of evidence regarding the impact of COVID-19 and the associated lockdown on young people with eating disorders. The goals of this study were 1) to examine characteristics of adolescents presenting for eating disorder (ED) assessment since the onset of the COVID-19 pandemic; 2) to compare adolescents presenting for ED assessment since the onset of the COVID-19 pandemic to those that presented for assessment 1 year previously; 3) to examine implications of the pandemic on the system of care. METHODS: A retrospective chart review was completed on all patients assessed at a pediatric tertiary care ED program during the pandemic between April 1 and October 31, 2020, and on youth assessed during the same time frame 1 year previously. Data including body measurements and results of psychological measures was extracted from patients' charts. Clinician reports were utilized for accounts of ED symptoms. Referrals to our program were also compared for the two time periods. RESULTS: Of the 48 youth assessed between April and October 2020, average age was 14.6 years and average percentage of treatment goal weight was 77.7%. 40% cited the pandemic as a trigger for their ED; of these youth, 78.9% were medically unstable compared to 55.2% of those whose ED was not triggered by the pandemic. When comparing the 2020 cohort to those assessed in 2019, youth who presented for assessment during the pandemic trended towards having lower percentage of goal weights and higher rates of self-reported impairment, and were significantly more likely to be medically unstable (p = 0.005) and to require hospitalization (p = 0.005). Higher rates of inpatient admissions, emergency room consultation requests and outpatient referrals deemed "urgent" were likewise associated with the pandemic period. CONCLUSIONS: During the COVID-19 pandemic, youth assessed for an ED presented with high rates of medical instability and need for hospitalization. Caring for these youth may be more challenging during the pandemic, when access to services may be limited. Further research is required to better understand the impact of the pandemic on the clinical course and outcomes of EDs in adolescents.
BACKGROUND: There is a noticeable lack of evidence regarding the impact of COVID-19 and the associated lockdown on young people with eating disorders. The goals of this study were 1) to examine characteristics of adolescents presenting for eating disorder (ED) assessment since the onset of the COVID-19 pandemic; 2) to compare adolescents presenting for ED assessment since the onset of the COVID-19 pandemic to those that presented for assessment 1 year previously; 3) to examine implications of the pandemic on the system of care. METHODS: A retrospective chart review was completed on all patients assessed at a pediatric tertiary care ED program during the pandemic between April 1 and October 31, 2020, and on youth assessed during the same time frame 1 year previously. Data including body measurements and results of psychological measures was extracted from patients' charts. Clinician reports were utilized for accounts of ED symptoms. Referrals to our program were also compared for the two time periods. RESULTS: Of the 48 youth assessed between April and October 2020, average age was 14.6 years and average percentage of treatment goal weight was 77.7%. 40% cited the pandemic as a trigger for their ED; of these youth, 78.9% were medically unstable compared to 55.2% of those whose ED was not triggered by the pandemic. When comparing the 2020 cohort to those assessed in 2019, youth who presented for assessment during the pandemic trended towards having lower percentage of goal weights and higher rates of self-reported impairment, and were significantly more likely to be medically unstable (p = 0.005) and to require hospitalization (p = 0.005). Higher rates of inpatient admissions, emergency room consultation requests and outpatient referrals deemed "urgent" were likewise associated with the pandemic period. CONCLUSIONS: During the COVID-19 pandemic, youth assessed for an ED presented with high rates of medical instability and need for hospitalization. Caring for these youth may be more challenging during the pandemic, when access to services may be limited. Further research is required to better understand the impact of the pandemic on the clinical course and outcomes of EDs in adolescents.
Authors: Andrea Phillipou; Denny Meyer; Erica Neill; Eric J Tan; Wei Lin Toh; Tamsyn E Van Rheenen; Susan L Rossell Journal: Int J Eat Disord Date: 2020-06-01 Impact factor: 5.791
Authors: Emily A Holmes; Rory C O'Connor; V Hugh Perry; Irene Tracey; Simon Wessely; Louise Arseneault; Clive Ballard; Helen Christensen; Roxane Cohen Silver; Ian Everall; Tamsin Ford; Ann John; Thomas Kabir; Kate King; Ira Madan; Susan Michie; Andrew K Przybylski; Roz Shafran; Angela Sweeney; Carol M Worthman; Lucy Yardley; Katherine Cowan; Claire Cope; Matthew Hotopf; Ed Bullmore Journal: Lancet Psychiatry Date: 2020-04-15 Impact factor: 27.083
Authors: Monika Gorny; Sarah Blackstock; Arun Bhaskaran; Imogen Layther; Mimoza Qoba; Carly Vassar; Jacob Ellis; Joanna Begent; John Forrester; Jon Goldin; Zoe Hallet; Tina Read; Sally Hodges; Michael Groszmann; Lee Duncan Hudson Journal: BMJ Paediatr Open Date: 2021-10-07
Authors: Alène Toulany; Paul Kurdyak; Astrid Guttmann; Thérèse A Stukel; Longdi Fu; Rachel Strauss; Lisa Fiksenbaum; Natasha R Saunders Journal: J Adolesc Health Date: 2021-10-22 Impact factor: 5.012