Increase in urgent care for patients with an eating disorder during the COVID-19 pandemic in a Spanish province

Irigoyen-Otiñano, María; González‐Pinto, Ana; Llorca-Bofí, Vicent; Adrados-Pérez, Marina; Arenas-Pijoan, Laura; Torterolo, Giovanni; Sánchez-Cazalilla, Marta; Buil, Esther; Nicolau-Subires, Eugènia; Albert-Porcar, Carla; Ibarra-Pertusa, Lucía; Puigdevall-Ruestes, Margarita

doi:10.1016/j.rpsm.2021.11.005

Cited by 11 publications

(6 citation statements)

References 22 publications

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“…Our results support our hypothesis that there was a statistically significant increase in patients with eating disorders presenting to this Emergency Department during the COVID-19 pandemic, despite an overall decrease in Emergency Department utilization. This is consistent with international data demonstrating overall both decrease in utilization of care during the pandemic, potentially due to fear around accessing care during the pandemic [1] and simultaneous increase in eating disorder symptomatology [3,12,13]. Our findings, while representative of a single-center study, are also consistent with additional Fig.…”

Section: Discussionsupporting

confidence: 92%

Presentation of Patients with Eating Disorders to a Pediatric Quaternary-Level Care Emergency Department During the COVID-19 Pandemic

2022

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Despite an overall decrease in utilization of emergency departments during COVID-19 (Hartnett et al. in MMWR Morb Mortal Wkly Rep. 69(23):699–704, 2020 ), US pediatric emergency departments experienced an increase in mental health visits for children and adolescents (Leeb et al. in MMWR Morb Mortal Wkly Rep. 69(45):1675–80, 2020 ). Simultaneously, individuals with eating disorders reported increasing symptomology (Termorshuizen et al. in Int J Eat Disord. 53(11):1780–90, 2020 ). This study compares Emergency Department utilization at a pediatric quaternary-level care center by patients with eating disorders during the pandemic (March–Dec 2020) vs March-Dec 2019. We hypothesize that there was an increase in presentation of patients with eating disorders. An Informatics for Integrating Biology and the Bedside query of the electronic medical record system identified patients with eating disorder diagnoses per ICD9/ICD10 codes aged 6–23 who presented to the Emergency Department between March 1 st and December 31 st of 2020 and 2019. Subsequent retrospective chart review was carried out. Patients were excluded from analysis if the presenting problem was not directly related to the eating disorder. During March–Dec 2019, 0.581% percent of all patients presented to the Emergency Department due to an eating disorder. During the same time frame in 2020, however, that percentage increased to 1.265%. Statistical significance was corrected using a Benjamini–Hochberg analysis. Despite a 66.5% decline in overall visits to the Emergency Department, the percentage of patients presenting with eating disorders doubled during the pandemic. During the pandemic, the total time spent awaiting placement significantly increased, and the number of patients identifying as transgender and/or nonbinary increased. Our data support the hypothesis that eating disorder presentation increased during the pandemic.

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Section: Discussionsupporting

confidence: 92%

Presentation of Patients with Eating Disorders to a Pediatric Quaternary-Level Care Emergency Department During the COVID-19 Pandemic

2022

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“…Except from the beginning of the pandemic in 2020, the end of 2021, and between February 2021-March 2021 among the youngest age group (18–24 years), the observed number of consultations exceeded the predicted number of consultations during both pandemic years. This is the opposite of what Mansfield et al [ 6 ] found in their study on primary care consultations in the general population, but supports findings from specialized health care on service use [ 47 – 49 ]. The divergent finding of Mansfield et al [ 6 ] might be due to sample differences, as our finding is in line with studies from specialized health care, where individuals have an existing mental disorder [ 47 – 49 ].…”

Section: Discussionsupporting

confidence: 73%

Contact with primary care physicians among adults with pre-existing common mental health problems during the COVID-19 pandemic: a registry-based study from Norway

Jensen,

Madsen,

Hauge

et al. 2023

BMC Health Serv Res

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Background During the COVID-19 pandemic, individuals with pre-existing mental health problems may have experienced additional stress, which could worsen symptoms or trigger relapse. Thus, this study aimed to investigate if the number of consultations with general practitioners (GPs) among individuals with a pre-existing common mental health problem during the pandemic differed from pre-pandemic years. Methods Data on consultations with GPs among 18–65-year-olds registered with common mental health problems in 2017–2021 were retrieved from the Norwegian Control and Payment of Health Reimbursements Database. Based on data from the pre-pandemic years (2017–2019), we predicted the number of consultations per week for depression, anxiety disorder, phobia/obsessive–compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders during the pandemic (March 2020-December 2021) among individuals with pre-existing mental health problems. The forecasted and observed trends in GP consultations per week during the pandemic were stratified by diagnosis, gender, and age groups. Results The observed number of consultations for anxiety disorder, PTSD, and eating disorders were significantly higher than forecasted during extended periods of the two pandemic years. The differences were largest for PTSD (on average 37% higher in men and 47% higher in women during the pandemic), and for eating disorders among women (on average 87% higher during the pandemic). There were only minor differences between the predicted and observed number of consultations for depression and phobia/OCD. Conclusions During the pandemic, individuals with a recent history of mental health problems were more likely to seek help for anxiety disorder, PTSD, and eating disorders, as compared to pre-pandemic years.

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“…According to our data, a diagnosis of depression or eating disorder in the ER during the con nements increased the risk of a subsequent suicide attempt by 3.1 and 1.5 respectively. Another study by our group has already shown an increase in suicidal behavior in patients of all ages with eating disorders during the period of con nement due to the pandemic 45 and other groups have also veri ed this 46 . These ndings are highly relevant as consistent longitudinal studies on suicide attempts and recidivism in youth during the pandemic are lacking.…”

Section: Discussionsupporting

confidence: 58%

Trajectories of children and adolescents attending a psychiatric emergency unit during the COVID-19 confinements: 2020-2022 longitudinal study

Adrados-Pérez

Llorca-Bofí

Mur-Laín

et al. 2023

Preprint

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Introduction: The prevalence of psychiatric disorders has not shifted widely through the COVID pandemic, except for some specific groups such as young people or women. Our objective is to examine prospectively the evolution of children and adolescents who consulted in a psychiatric emergency service during the COVID-19 confinements. Method: We collected prospective clinical information about 296 young people under 18 who visited a tertiary hospital for psychiatric reasons during the confinement periods in Spain. Clinical diagnoses, suicide attempts, hospital admissions, and pharmacological prescriptions were extracted from electronic health records through 2020, 2021, and 2022. Features of those who maintained psychiatric care and those who did not were compared. Results: Three out of four children and adolescents who visited the psychiatric emergency department during the confinements continued psychiatric care at the end of 2022. Those who did not showed better premorbid adjustment at baseline. During follow-up, diagnoses of neurodevelopmental disorders and eating disorders, as well as the dosage of psychotropic drug prescriptions, increased. The diagnoses of major depressive disorder and eating disorder at baseline were associated with attempting suicide during follow-up. Patients with internalizing symptoms were admitted earlier than those with externalizing symptoms but no differences were found in terms of suicide attempts. Conclusions: The continuity of psychiatric care after an initial emergency visit during the confinements implied greater clinical severity, as reflected by changes in clinical diagnoses and pharmacological regimens. Emergent symptoms of depression or eating disorders after social distancing or isolation could predict subsequent suicidal behavior in young populations.

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Increase in urgent care for patients with an eating disorder during the COVID-19 pandemic in a Spanish province

Cited by 11 publications

References 22 publications

Presentation of Patients with Eating Disorders to a Pediatric Quaternary-Level Care Emergency Department During the COVID-19 Pandemic

Presentation of Patients with Eating Disorders to a Pediatric Quaternary-Level Care Emergency Department During the COVID-19 Pandemic

Contact with primary care physicians among adults with pre-existing common mental health problems during the COVID-19 pandemic: a registry-based study from Norway

Trajectories of children and adolescents attending a psychiatric emergency unit during the COVID-19 confinements: 2020-2022 longitudinal study

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