Eating disorders and COVID-19 - different or just more?

Author:

Rafferty CathalORCID,O’Donnell Angela,Campbell Sally,Sun Bohan,King Jenny,Ali Zeinab,Lynch Diarmuid,Barrett Elizabeth,Richardson Sarah,Clifford Michelle,McNicholas Fiona

Abstract

Abstract Background COVID-19 saw an increase in child mental health presentations internationally. Clinicians analogised the exponential increase in anorexia nervosa to a ‘tsunami’ or ‘outbreak’, raising parallel concerns regarding medical and psychological risks (Marsh in The Guardian, 2021; Leask in NZ Herald, 2021; Monteleone et al. in Eat Weight Disord 26(8):2443–2452, 2021) . It is unclear whether Ireland emulated this picture of increased referrals with increased medical compromise. Aims This paper examines both rates and clinical profiles of child eating disorder presentations in the Republic of Ireland (ROI), across different clinical settings. Methods Following ethical approval, retrospective chart reviews were conducted in a community eating disorder service and in two paediatric hospital settings. The time frame of the different studies ranged from January 2016 to December 2022. Results Community eating disorder services saw significantly higher referral rates post COVID-19 (3.78/month vs. 2.31/month, p = 0.02), with a shorter duration of illness (4.8 months vs. 7.4 months, p = 0.001), but no significant difference in ideal body weight % (IBW%) at referral (85.32% vs. 83.7%, p = 0.1). Both paediatric hospitals witnessed significantly increased referrals post-COVID-19 (hospital 1; 4.38/month vs. 1.93/month, p = 0.0001; hospital 2; 2.8/month vs. 0.92/month, p < 0.0001), but no significant difference in IBW% at assessment (hospital 1; 82.7% vs. 81.39%, p = 0.673; hospital 2; 81.5% vs. 83%, p = 0.563). There was no significant difference in clinical profile, management, or duration of hospital stay. Conclusions This study supports the growing consensus of a pandemic specific increase in eating disorder referrals to both medical and psychiatry services. However, there was little to indicate a change in clinical profile or severity. Ongoing monitoring of referrals is necessary to ensure adequate service availability and expertise.

Funder

University College Dublin

Publisher

Springer Science and Business Media LLC

Reference23 articles.

1. Marsh S (2021) Doctors warn of “tsunami” of pandemic eating disorders. The Guardian. https://www.theguardian.com/society/2021/feb/11/doctors-warn-of-tsunami-of-pandemic-eating-disorders. Accessed 26 June 2023

2. Leask A (2021) “Tsunami” of child eating disorders emerging after lockdowns in New Zealand. The New Zealand Herald. https://www.nzherald.co.nz/nz/covid-19-coronavirus-tsunami-of-child-eating-disorders-emerging-after-lockdowns-in-new-zealand/M3ZHGQ4ICG72OUMRMFDOLN25CY/. Accessed 26 June 2023

3. Monteleone AM, Cascino G, Marciello F et al (2021) Risk and resilience factors for specific and general psychopathology worsening in people with Eating Disorders during COVID-19 pandemic: a retrospective Italian multicentre study. Eat Weight Disord 26(8):2443–2452. https://doi.org/10.1007/s40519-020-01097-x

4. McNicholas F, Kelleher I, Hedderman E et al (2021) Referral patterns for specialist child and adolescent mental health services in the Republic of Ireland during the COVID-19 pandemic compared with 2019 and 2018. BJPsych open 7(3):e91. https://doi.org/10.1192/bjo.2021.48

5. McDonnell T, Barrett M, McNicholas F et al (2021) Increased mental health presentations by children aged 5–15 at emergency departments. Ir Med J 114(5):356–356

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