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

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

*Corresponding author for this work

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Abstract

PurposeTo examine implications of the COVID-19 pandemic on eating disorder (ED) features and psychopathology in female adolescents with anorexia nervosa (AN).MethodIn 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.ResultsPeri-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.ConclusionOverall, 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 evidenceLevel III: Evidence obtained from well-designed cohort or case-control analytic studies.
Original languageEnglish
Article number13
Number of pages16
JournalEating and Weight Disorders
Volume29
Issue number1
DOIs
Publication statusPublished - Dec 2024

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