COVID-19-related changes in eating disorder pathology, emotional and binge eating and need for care: a systematic review with frequentist and Bayesian meta-analyses

Guzel, Âmine; Mutlu, Naz Lâl; Molendijk, Marc L.

doi:10.1007/s40519-023-01547-2

Cited by 19 publications

(17 citation statements)

References 98 publications

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“…Still, we found a significant increase in the admission rate of trifold-affected youth showing ED, DD, and AD, indicating a small group of patients with ED with strongly increased severe mental health problems during COVID-19. Other studies reported a generally increased DD comorbidity in ED inpatients ( 25 , 28 ) but, similar to our results, no changes in AD comorbidity rates ( 28 , 43 , 45 ).…”

Section: Discussionsupporting

confidence: 90%

Admission rates and clinical profiles of children and youth with eating disorders treated as inpatients before and during the COVID-19 pandemic in a German university hospital

Silber,

Platte,

Kumar

et al. 2023

Front. Public Health

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IntroductionChildren and youth at risk for mental health disorders, such as eating disorders (ED), were particularly affected by the COVID-19 pandemic, yet evidence for the most seriously affected and thus hospitalized youth in Germany is scarce.MethodsThis crosssectional study investigated anonymized routine hospital data (demographic information, diagnoses, treatment modalities) of patients admitted (n = 2,849) to the Department of Child and Adolescence Psychiatry, Psychosomatics and Psychotherapy (DCAPPP) of a German University Hospital between 01/2016 and 02/2022. Absolute and relative number of inpatients with or without ED prior to (01/2016–02/2020) and during the COVID-19 pandemic (03/2020–02/2022) were compared. The effect of school closures as part of social lockdown measures for COVID-19 mitigation on inpatient admission rate was explored as it has been discussed as a potential risk factor for mental health problems in youth.ResultsDuring the COVID-19 pandemic, ED inpatient admission rate increased from 10.5 to 16.7%, primarily driven by Anorexia Nervosa (AN). In contrast to previous reports, we found no change in somatic and mental disorder comorbidity, age or sexratio for hospitalized youth with ED. However, we did observe a shortened length of hospital stay (LOS) for hospitalized youth with and without ED. In addition, non-ED admissions presented with an increased number of mental disorder comorbidities. In contrast to our hypothesis, school closures were not related to the observed increase in ED.DiscussionIn summary, the COVID-19 pandemic was associated with an increased rate of inpatient treatment for youth suffering from AN, and of youth affected by multiple mental disorders. Accordingly, we assume that inpatient admission was prioritized for individuals with a higher burden of disease during the COVID-19 pandemic. Our findings pinpoint the need for adequate inpatient mental health treatment capacities during environmental crises, and a further strengthening of child and adolescence psychiatry services in Germany.

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Section: Discussionsupporting

confidence: 90%

Admission rates and clinical profiles of children and youth with eating disorders treated as inpatients before and during the COVID-19 pandemic in a German university hospital

Silber,

Platte,

Kumar

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…The COVID-19 pandemic has exerted a negative effect on the prevalence rates of eating disorders (EDs), their symptoms, psychiatric comorbidity, and the need for care, but the range and the magnitude of this effect is still unknown. Indeed, many results suggest that the COVID-19 pandemic was associated with a widespread negative effect on EDs in patients and in the general population [3]. A systematic review synthesizes the impact of the COVID-19 pandemic on BED new onset and course, in particular after the introduction of restrictive measures to reduce the infection (lockdown), confirming its negative impact [4].…”

Section: Introductionmentioning

confidence: 94%

Screening, Diagnosis, and Treatment of Patients with Binge Eating Disorder and Obesity: What the Endocrinologist Needs to Know

Marucci,

Busetto,

Chianelli

et al. 2024

Endocrines

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Binge eating disorder (BED) is the most common eating disorder categorized in the DSM-V, but it is often not diagnosed in patients with obesity because it can be difficult to detect in these patients who often have altered eating patterns. In this narrative review, we have highlighted the most recent findings in the screening, diagnosis, and treatment of patients with BED and obesity. The results of our search showed that many BED patients are not obese, and most people with obesity do not have binge behavior. In the diagnostic assessment of these patients, it is important to evaluate not only the clinical and nutritional status and the presence of medical comorbidities, but also the psychological signs and symptoms related to psychiatric comorbidities to define the appropriate diagnosis and the consequent level of treatment. Well-tolerated drugs with action on both body weight and binges can be useful as a second-line complement to cognitive behavioral therapy (CBT). Specific guidelines are needed to obtain consensus on appropriate recommendations in patients with obesity and BED approaching bariatric surgery, taking into account not only weight reduction and clinical data, but also eating behaviors. Identification of BED is important for targeting individuals at high risk of obesity, adverse metabolic patterns, and cardiovascular disease. The challenge is to also achieve lasting weight loss in patients with BED and concomitant obesity.

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“…Any potential doubts about the impact of COVID-19 on mental health have been largely put to rest by the most recent papers on the topic [ 90 , 91 , 92 , 93 , 94 ]. Loneliness, physical exhaustion, sleep disturbances, and anhedonia linked to compulsive or addictive behaviors such as binge-eating [ 95 , 96 ], substance abuse [ 97 ], and digital reward craving [ 98 ] were identified asbeing linked to suicidal ideation [ 95 , 99 , 100 ]—in particular, in younger individuals—during and after the pandemic. These reflect some of the most negative effects of pandemic-related adversity on mental health worldwide.…”

Section: Covid-19 Pandemic and Mental Healthmentioning

confidence: 99%

From Reward to Anhedonia-Dopamine Function in the Global Mental Health Context

Dresp-Langley

2023

Biomedicines

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When “hijacked” by compulsive behaviors that affect the reward and stress centers of the brain, functional changes in the dopamine circuitry occur as the consequence of pathological brain adaptation. As a brain correlate of mental health, dopamine has a central functional role in behavioral regulation from healthy reward-seeking to pathological adaptation to stress in response to adversity. This narrative review offers a spotlight view of the transition from healthy reward function, under the control of dopamine, to the progressive deregulation of this function in interactions with other brain centers and circuits, producing what may be called an anti-reward brain state. How such deregulation is linked to specific health-relevant behaviors is then explained and linked to pandemic-related adversities and the stresses they engendered. The long lockdown periods where people in social isolation had to rely on drink, food, and digital rewards via the internet may be seen as the major triggers of changes in motivation and reward-seeking behavior worldwide. The pathological adaptation of dopamine-mediated reward circuitry in the brain is discussed. It is argued that, when pushed by fate and circumstance into a physiological brain state of anti-reward, human behavior changes and mental health is affected, depending on individual vulnerabilities. A unified conceptual account that places dopamine function at the centre of the current global mental health context is proposed.

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COVID-19-related changes in eating disorder pathology, emotional and binge eating and need for care: a systematic review with frequentist and Bayesian meta-analyses

Cited by 19 publications

References 98 publications

Admission rates and clinical profiles of children and youth with eating disorders treated as inpatients before and during the COVID-19 pandemic in a German university hospital

Admission rates and clinical profiles of children and youth with eating disorders treated as inpatients before and during the COVID-19 pandemic in a German university hospital

Screening, Diagnosis, and Treatment of Patients with Binge Eating Disorder and Obesity: What the Endocrinologist Needs to Know

From Reward to Anhedonia-Dopamine Function in the Global Mental Health Context

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