scholarly journals The impact of COVID-19 on eating disorder referrals and admissions in Waikato, New Zealand

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Sara J. Hansen ◽  
Alice Stephan ◽  
David B. Menkes
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
New Zealand ◽  
Hospital Admissions ◽  
Resource Constraints ◽  
English Summary ◽  
Outpatient Services ◽  
Patient Admissions ◽  
Clinical Records ◽  
The Impact

Abstract Background Several countries have reported increased demand for eating disorder services during the COVID-19 pandemic, particularly for adolescents. Within New Zealand, anecdotal and media reports suggest similar changes but are limited in scope and detail. We assessed eating disorder service demand in the Waikato district in relation to the COVID-19 pandemic. Methods We retrospectively analysed records of eating disorder admissions and referrals for both children (< 18 years) and adults (≥ 18 years) during 2019 and 2020 in the Waikato, a mixed urban–rural province in northern New Zealand (population 435,000). We analysed medical admission and outpatient referral rates, and referral acuity, in relation to the COVID-19 pandemic using Welch’s t- and chi-square tests. Results 106 medical admissions met inclusion criteria (n = 37 in 2019; 69 in 2020). Admissions for eating disorders increased markedly following nationwide lockdown in March 2020 (RR = 1.7, p = 0.01), largely driven by increases in adult admissions (RR 2.0, p = 0.005). The proportion of ‘new patient’ admissions showed comparable increases for both children (RR = 2.0, p = 0.02) and adults (RR = 2.3, p = 0.03). Following lockdown, outpatient referrals increased in acuity (RR = 1.8, p = 0.047) and volume (RR = 1.6, p = 0.076) for children but not for adults. Conclusions Our study confirms a pandemic-related increase in demand for eating disorder services in the Waikato region of New Zealand, consistent with findings reported overseas. We observed contrasting increases in admissions for adults and outpatient referrals for children, exacerbating resource constraints for already stretched services and compromising provision of timely care. Plain English summary The COVID-19 pandemic has been linked to increased numbers and worsening severity of eating disorders in several settings. In New Zealand, similar trends have been noted anecdotally. We assessed clinical records to calculate rates of eating disorder-related hospital admissions and outpatient referrals during 2019 and 2020. We found significant increases in hospital admissions related to COVID-19, particularly for adults, and greater proportions of both children and adults having a first-ever eating disorder-related admission. In outpatient services, young people were referred more frequently during the pandemic and were more physically unwell when referred. These results indicate increased demand for eating disorder services as a result of the pandemic and complement findings reported overseas.

scholarly journals Longitudinal experiences and impact of the COVID-19 pandemic among people with past or current eating disorders in Sweden

2021 ◽  
Author(s):  
Andreas Birgegård ◽  
Afrouz Abbaspour ◽  
Stina Borg ◽  
David Clinton ◽  
Emma Forsén Mantilla ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Data Availability ◽  
Evidence Based ◽  
List Type ◽  
Convenience Sample ◽  
Eating Disorder Symptom ◽  
Disorder Symptom ◽  
Evidence Based Care ◽  
The Impact

AbstractObjectiveTo document the impact of the COVI-19 pandemic on the health and well-being of individuals with past and current eating disorders in Sweden.MethodWe re-contacted participants from two previous Swedish studies who had a known lifetime history of an eating disorder. Participants completed an online questionnaire about their health and functioning at baseline early in the pandemic (Wave 1; N=982) and six months later (Wave 2); N=646).ResultsThree important patterns emerged: 1) higher current eating disorder symptom levels were associated with greater anxiety, worry, and pandemic-related eating disorder symptom increase; 2) patterns were fairly stable across time, although a concerning number who reported being symptom-free at Wave 1 reported re-emergence of symptoms at Wave 2; and only a minority of participants with current eating disorders were in treatment, and of those who were in treatment, many reported fewer treatment sessions than pre-pandemic and decreased quality of care.ConclusionsThe COVID-19 pandemic is posing serious health challenges for individuals with eating disorders, whether currently symptomatic or in remission. We encourage health service providers and patient advocates to be alert to the needs of individuals with eating disorders and to take active measures to ensure access to appropriate evidence-based care both during and following the pandemic.Significant Outcomes and LimitationsIndividuals with eating disorders symptoms or current active disorder report higher adverse impact of COVID-19 on their mental healthEven individuals who were symptom-free early in the pandemic reported a resurgence of eating disorder symptomsA large proportion of symptomatic individuals were not in treatment for their eating disorder, services should be aware and access to evidence-based care should be ensured across SwedenLimitations included the use of a convenience sample with atypical diagnostic distribution, and a low initial response rate, possibly introducing bias and limiting generalisability.Data Availability StatementFully anonymized data are available from the corresponding author upon request.

scholarly journals The Impact of Retrospective Childhood Maltreatment on Eating Disorders as Mediated by Food Addiction: A Cross-Sectional Study

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2969 ◽  
Author(s):  
Rami Bou Khalil ◽  
Ghassan Sleilaty ◽  
Sami Richa ◽  
Maude Seneque ◽  
Sylvain Iceta ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Childhood Maltreatment ◽  
Emotional Abuse ◽  
Food Addiction ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Yale Food Addiction Scale ◽  
Physical Neglect ◽  
The Impact

Background: The current study aimed to test whether food addiction (FA) might mediate the relationship between the presence of a history of childhood maltreatment and eating disorder (ED) symptom severity. Methods: Participants were 231 patients with ED presenting between May 2017 and January 2020 to a daycare treatment facility for assessment and management with mainly the Eating Disorder Inventory-2 (EDI-2), the Child Trauma Questionnaire (CTQ), and the Yale Food Addiction Scale (YFAS 2.0). Results: Participants had a median age of 24 (interquartile range (IQR) 20–33) years and manifested anorexia nervosa (61.47%), bulimia nervosa (16.88%), binge-eating disorders (9.09%), and other types of ED (12.55%). They were grouped into those likely presenting FA (N = 154) and those without FA (N = 77). The group with FA reported higher scores on all five CTQ subscales, as well as the total score of the EDI-2 (p < 0.001). Using mediation analysis; significant indirect pathways between all CTQ subscales and the EDI-2 total score emerged via FA, with the largest indirect effect emerging for physical neglect (standardized effect = 0.208; 95% confidence interval (CI) 0.127–0.29) followed by emotional abuse (standardized effect = 0.183; 95% CI 0.109–0.262). Conclusion: These results are compatible with a model in which certain types of childhood maltreatment, especially physical neglect, may induce, maintain, and/or exacerbate ED symptoms via FA which may guide future treatments.

scholarly journals Revisiting the Postulates of Etiological Models of Eating Disorders: Questioning Body Checking as a Longer-Term Maintaining Factor

2022 ◽  
Vol 12 ◽  
Author(s):  
Vanessa Opladen ◽  
Maj-Britt Vivell ◽  
Silja Vocks ◽  
Andrea S. Hartmann
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Negative Affect ◽  
Negative Emotion ◽  
Body Checking ◽  
Eating Disorder Symptoms ◽  
Positive Effects ◽  
General Pathology ◽  
Before And After ◽  
The Impact

Body checking (BC) is not only inherent to the maintenance of eating disorders but is also widespread among healthy females. According to etiological models, while BC serves as an affect-regulating behavior in the short term, in the longer term it is assumed to be disorder-maintaining and also produces more negative affect. The present study therefore aimed to empirically examine the proposed longer-term consequences of increased BC. In an online study, N = 167 women tracked their daily amount of BC over a total of 7 days: Following a 1-day baseline assessment of typical BC, participants were asked to check their bodies in an typical manner for 3 days and with a 3-fold increased frequency for 3-days. Before and after each BC episode, the impact of BC on affect, eating disorder symptoms, general pathology and endorsement of different functions of BC was assessed. Participants showed longer-term consequences of increased BC in terms of increased negative affect and general pathology, while eating disorder symptoms remained unaffected. In the case of typical BC, participants showed decreased general pathology and anxiety. Furthermore, the endorsement of a higher number of BC functions led to increased negative affect and an increased amount of typical BC. The findings support the theoretically assumed role of maladaptive BC in maintaining negative emotion in the longer term. However, though requiring replication, our finding of positive effects of typical BC calls into question the overall dysfunctionality of BC among non-clinical women who are not at risk of developing an eating disorder.

scholarly journals “It is the only constant in what feels like a completely upside down and scary world”: Living with an Eating Disorder during COVID-19 and the importance of perceived control for recovery and relapse.

2021 ◽  
Author(s):  
Dawn Branley-Bell ◽  
Catherine V. Talbot
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Perceived Control ◽  
Online Survey ◽  
Negative Impact ◽  
Significant Risk ◽  
Study Data ◽  
External Control ◽  
Time Points ◽  
The Impact

Background: The COVID-19 pandemic has had a profound, negative impact on the lives and wellbeing of the population, and it can raise additional challenges for individuals with eating disorders. During early stages of the UK lockdown, individuals reported disruptions to many aspects of their lives, including reduced feelings of control and serious concerns over the impact of the pandemic on eating disorder symptoms and/or recovery. This study compares data from two time points to explore the ongoing impacts of the pandemic on this population. Method: A mixed-methods online survey was developed for the purpose of this study. Data was collected at the two key time points: First, soon after the start of the first UK lockdown (April 2020) and second, as the first lockdown restrictions began to be lifted (June 2020). The sample consisted of 58 individuals currently experiencing, or in recovery from, an eating disorder. Participants were aged between 16-65 years; 57 identified as female, and 1 male. Results: Higher perceptions of general, external control were associated with recovery between the time points. Individuals who experienced less perceived control reported a tendency to rely upon eating disorder behaviours as an auxiliary coping mechanism, i.e., diminished external control was directed inwards and replaced with controlling their own behaviour. Conclusions: Perceived control is a significant factor in eating disorder recovery. As a result of the pandemic’s negative impact upon peoples’ sense of control, individuals with eating disorders are at significant risk of detrimental impacts on their recovery and wellbeing. The results have implications for future treatments based on strengthening individuals’ perceptions of control to promote recovery.

scholarly journals Exploring the impact of the COVID-19 pandemic and UK lockdown on individuals with experience of eating disorders

2020 ◽  
Author(s):  
Dawn Branley-Bell ◽  
Catherine V. Talbot
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Social Isolation ◽  
Technology Use ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Psychological Wellbeing ◽  
Living Situation ◽  
Negative Impacts ◽  
The Impact

Background: The coronavirus disease 2019 (COVID-19) pandemic may raise unique challenges for individuals with experience of eating disorders. Many factors have potential for detrimental impacts on psychological wellbeing and eating disorder recovery, including: Disruption to living situations, ‘social distancing’ restrictions, difficult access to healthcare, and societal changes to food behaviours and technology usage. To date, little is known on the impact of the pandemic on this population particularly within the UK.Method: A mixed-methods online survey was developed for the purpose of this study. Data was collected from 129 individuals currently experiencing, or in recovery from, an eating disorder during the early stages of the UK pandemic lockdown. Participants were aged between 16-65 years, with 121 participants identifying as female, 7 male and 1 participant preferring not to disclose their gender.Results: Findings suggest that the pandemic is having a profound, negative impact upon individuals with experience of eating disorders. 8 key themes are generated: Disruption to living situation, increased social isolation and reduced access to usual support networks, changes to physical activity rates, reduced access to healthcare services, disruption to routine and perceived control, changes to relationship with food, increased exposure to triggering messages, and positive outcomes. The results suggest detrimental impacts on psychological wellbeing including decreased feelings of control, increased feelings of social isolation, increased rumination about disordered eating, and low feelings of social support.Conclusions: Individuals with eating disorders are at significant risk of negative impacts of the pandemic. There is a vital need for interventions to support this population. Inequalities in healthcare provision were identified, emphasising a need for a more cohesive approach to remote treatment across UK healthcare services. Positive aspects of technology use were identified but the results suggest a need to address and/or limit the potential for negative impacts of public messages around food and exercise behaviours, and to co-design technologies with end-users to facilitate effective treatment.

scholarly journals Long-term trends of hospital admissions among patients with cancer following the 2015 earthquake: a single institution observational study in Kathmandu, Nepal

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026746 ◽  
Author(s):  
Anup Uprety ◽  
Akihiko Ozaki ◽  
Asaka Higuchi ◽  
Bikal Ghimire ◽  
Toyoaki Sawano ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Low Income ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Patients With Cancer ◽  
Nepal Earthquake ◽  
Patient Admissions ◽  
The Impact ◽  
2015 Nepal Earthquake

ObjectivesLittle is known regarding how natural disasters affect patients with cancer in low-income and middle-income countries. The objective of the present study was to assess the impact of the 2015 Nepal earthquake on the admission of patients with cancer at a core medical institution in Kathmandu.Design, setting and participantsWe considered all 3520 cancer patient admissions to Tribhuvan University Teaching Hospital, from 25 April 2013 to 24 April 2017 (2 years before and 2 years after the earthquake).Outcome measuresThe number of cancer patient admissions was calculated for each month. Using a negative binomial model, we estimated the incidence rate ratio (IRR) for admission numbers each month after the earthquake compared with the pre-earthquake baseline and investigated chronological change.ResultsThe total admission number in the first month after the earthquake was decreased compared with that of the predisaster baseline (IRR=0.66, 95% CI 0.43 to 1.00), which largely reflected decreased admissions of patients from outside of the most disaster-affected districts. From the second month, the admission number consistently exceeded the predisaster baseline for the remaining postdisaster period. In contrast to the month of the disaster, the continuation of increased admissions was most prominent among those from outside of the most affected districts.ConclusionsAfter a transient decrease immediately following the 2015 Nepal earthquake, there was a long-term increase in cancer patient admissions in a core hospital in Kathmandu. These changes were seen most prominently in patients from outside the most disaster affected areas.

scholarly journals 12 Impact of Aripiprazole Long-acting Injectable (ALAI) Initiation on Hospitalizations and Visits to Emergency

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 179-180
Author(s):  
Carlos Parro-Torres ◽  
Elena Ros-Cucurull ◽  
Sergio Arques-Egea
Keyword(s):  
Blood Pressure ◽  
Emergency Service ◽  
Hospital Admissions ◽  
Psychiatric Service ◽  
Mirror Image ◽  
Wilcoxon Test ◽  
Dual Disorders ◽  
Long Acting ◽  
Clinical Records ◽  
The Impact

AbstractBackgroundAripiprazole once-monthly is an LAI formulation of aripiprazole that is currently approved in the USA and Europe for the treatment of schizophrenia. Some studies have reported a decline in hospital admissions and emergency use after initiation on long-acting injectable (LAI) antipsychotics, but the effects of using recently commercialised LAI aripiprazole remains uncertain.AimsTo characterize the impact of ALAI initiation on number of hospitalizations and visits to the emergency service, among patients suffering from schizophrenia attending regularly to psychiatric consultations of Gregorio Marañón University General Hospital (Madrid, Spain).MethodsPatients initiated on (ALAI) were studied in an observational mirror-image design to assess changes in number of hospitalizations and visits to the emergency service in the 12months pre- vs 12months post-depot initiation. Other sociodemographic, physical and clinical variables such as age, gender, weight, blood pressure and presence of dual disorders were also gathered. Variables were collected reviewing clinical records.Wilcoxon test was used to assess hospitalizations and visits to the emergency. Paired t-tests were used to assess changes in weight and blood pressure. Non parametric Mann-Whitney U test was used to compare aripiprazole doses between genders and in order to assess de influence of dual disorders. In order to perform the statistical analysis, IBM SPSS statistics v.20 was used.Results31 patients were included in the final analysis. Mean age was 44.67 (SD=15.57) years. Most of the patients were male (54.8% vs 45.2%). 71% were previously receiving oral antipsychotics treatment, whereas 29% were receiving other LAI antipsychotic: no significant differences were observed when comparing hospitalizations (p=0.74) or emergency use (p=0.98) in the 12months post-initiation between these groups. Mean dosage was 352.67mg/28days (SD=0.461), and 38.7% needed an adjustment during the first year of treatment (dosage increased in 76.9%). A combination of two or more antipsychotics was prescribed in 64.5% of the patients. Mean psychiatric number of hospitalizations a year declined from 0.483/year pre-initiation to 0.224/year post-initiation (P<0.05), whereas mean visits a year to the emergency psychiatric service declined from 1.419 pre-initiation to 1.032 post-initiation (P<0.1). No significant changes in weight (p=0.82), systolic (p=0.56) or diastolic (p=0.29) blood pressure were observed. No gender differences in dosage were observed (p=0.246). Suffering from dual disorders had no influence on dosage either (p=0.68).ConclusionsLAI aripiprazole initiation appears to provide a benefit decreasing hospitalization needs and emergency services consumption and it was well tolerated. This data supports previous evidence indicating superiority of LAI antipsychotics.

scholarly journals Early Improvement in Eating Attitudes during Cognitive Behavioural Therapy for Eating Disorders: The Impact of Personality Disorder Cognitions

2013 ◽  
Vol 42 (2) ◽  
pp. 224-237 ◽  
Author(s):  
Emma C. Park ◽  
Glenn Waller ◽  
Kenneth Gannon
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Eating Attitudes ◽  
Drop Out ◽  
Cognitive Behavioural ◽  
The Impact

Background: The personality disorders are commonly comorbid with the eating disorders. Personality disorder pathology is often suggested to impair the treatment of axis 1 disorders, including the eating disorders. Aims: This study examined whether personality disorder cognitions reduce the impact of cognitive behavioural therapy (CBT) for eating disorders, in terms of treatment dropout and change in eating disorder attitudes in the early stages of treatment. Method: Participants were individuals with a diagnosed eating disorder, presenting for individual outpatient CBT. They completed measures of personality disorder cognitions and eating disorder attitudes at sessions one and six of CBT. Drop-out rates prior to session six were recorded. Results: CBT had a relatively rapid onset of action, with a significant reduction in eating disorder attitudes over the first six sessions. Eating disorder attitudes were most strongly associated with cognitions related to anxiety-based personality disorders (avoidant, obsessive-compulsive and dependent). Individuals who dropped out of treatment prematurely had significantly higher levels of dependent personality disorder cognitions than those who remained in treatment. For those who remained in treatment, higher levels of avoidant, histrionic and borderline personality disorder cognitions were associated with a greater change in global eating disorder attitudes. Conclusions: CBT's action and retention of patients might be improved by consideration of such personality disorder cognitions when formulating and treating the eating disorders.

Developments in Eating Disorders Research

2020 ◽  
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Health And Wellbeing ◽  
The Impact

As everyone's thoughts are dominated by the impact of COVID-19 on mental health and wellbeing, it seems pertinent to start by thinking how people with or at risk of eating disorders may have been affected. Research suggests that the impacts differ according to the type of eating disorder concerns and behaviours.

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