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

Author:

Bracké Katrien,Steegers Cathelijne,van der Harst Tess,Pons Rozemarijn,Legerstee Jeroen,Dierckx Bram,de Nijs Pieter,Bax-van Berkel Marieke,van Elburg Annemarie,Hekkelaan Marion,Hokke Joke,de Jong-Zuidema Hetty,Korthals Altes Lucas,Lengton-van der Spil Farida,Luijkx Judith,Schuurmans Femke,Smeets Carien,van Wijk Lia,Woltering Claire,Vernooij Meike,Hillegers Manon,White Tonya,Dieleman Gwen

Abstract

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.

Funder

Sophia Foundation for Scientific Research

Internal Erasmus MV grant of the department of Radiology and Nuclear Medicine of the Erasmus University Medical Center.

Intramural Research Program from the National Institutes of Mental Health

Publisher

Springer Science and Business Media LLC

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