A retrospective cohort study on the impact of the COVID-19 global pandemic on assessments and hospital admissions within a specialist adolescent eating disorder service

Abstract

Abstract Eating disorder services worldwide were impacted by the COVID-19 pandemic experience, including its associated counter-measures. We examined the effect of the pandemic on sociodemographic and clinical characteristics of young people assessed and admitted by a specialist adolescent eating disorder service in the Northwest of England (UK). Routinely collected electronic data in the two years following the World Health Organisation declaration of a global pandemic in March 2020, was compared with data collected in the preceding two years. This service experienced a 21% increase in assessments from the two years pre-COVID (n=78) to the two years following the pandemic onset (n=120), Inpatient admissions also increased by 10%. The pandemic had no effect on admission setting, with approximately 20% admitted to specialist eating disorder units, 40% to paediatric wards and 40% to adolescent mental health units, consistently across the four years. No significant difference in sociodemographic characteristics of young people within the service before or during the pandemic was found. However, self-rated eating disorder pathology at assessment was significantly more severe following the pandemic. Fewer admission had a recorded comorbid diagnosis of an Autistic Spectrum Condition following the pandemic compared to those admitted pre-pandemic. These findings quantify the increase in demand for highly specialist adolescent eating disorder services since the start of the COVID-19 pandemic, with a higher severity of psychopathology managed outside of hospital. This has implications for service design, allocation of resources and future delivery of appropriate models of care to young people.