Seasonality of hospital admissions and birth dates among inpatients with eating disorders: a nationwide population-based retrospective study

Liang, Chih‐Sung; Chung, Chi‐Hsiang; Tsai, Chia‐Kuang

doi:10.1007/s40519-016-0326-0

Cited by 6 publications

(5 citation statements)

References 33 publications

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“…In the present study, the treatment prevalence rate of ED was 85.6 per 10 5 inhabitants aged ≧20, in a 15‐year follow‐up. In one study using the NHIRD, the one‐year prevalence rate of ED was 20.87 per 10 5 inhabitants aged 10–34 (Tsai et al, 2018), and another study has reported a rate of 14.87 per 10 5 patients with the records of hospitalizations for any reasons, between 2000 and 2013, with the ranges of age in AN as 15–19 years and BN as 20–24 years, which were close to that in our study (C. S. Liang et al, 2018). The differences of ED prevalence among these studies might be related to the sampling: we have sampled the ED outpatients and inpatients aged ≧20 from the LHID, rather than samples consisting of younger and hospitalized patients in the previous studies.…”

Section: Discussionsupporting

confidence: 90%

“…There were 77.4% of female ED patients in this study. The female-predominance in the present study finding is similar to the findings in the aforementioned studies (C. S. Liang et al, 2018;Tsai et al, 2018).…”

Section: Comparison Of This Study To Previous Literaturesupporting

confidence: 92%

“…We conducted a nationwide retrospective cohort study based on patients (≥20 years) with the diagnosis of ED, and the threshold of age inclusion was referenced with one previous study about EDs (C. S. Liang, Chung, Tsai, & Chien, 2018). Also, the incidence and prevalence of ED peaked at ages 20-24 in females and ages 25-29 in males (Tsai et al, 2018), therefore, we focused this study on adult patients age ≥ 20 years.…”

Section: Study Design and Sampled Participantsmentioning

confidence: 99%

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Eating disorders and the risk of esophageal and stomach cancers‐A nationwide, population‐based cohort study in Taiwan

Yeh

Chien

Chung

et al. 2020

Intl J Eating Disorders

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Background: Previous studies have shown elevated cancer risk in anorexia nervosa but the literature on other eating disorders (EDs) is scarce. This study aimed to investigate the association between all EDs and esophageal, stomach, and other cancers.Methods: We used a retrospective cohort design, based on a two-million randomized longitudinal health insurance dataset, a sub-dataset of Taiwan's National Health Insurance Research Database. From all the potential participants aged 20 years or more, a total of 6,628 participants were enrolled, including 1,657 patients with EDs, with sex-, age-, and indexed date-matched (1:3) 4,971 controls. Each participant was individually tracked from 2000 to 2015 to identify incident cases of cancers, including esophageal cancer (EC), stomach cancer (SC), and all other cancers (AOC). The multivariate Cox proportional hazards model was employed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between EDs and cancer.Results: Of the total 6,628 enrollees, 222 in 1,657 individuals with EDs and 810 in the 4,971 non-ED control individuals developed cancer (1,262.40 vs. 1,472.15 per 100,000 person-years), and the Kaplan-Meier survival analysis was not statistically significant (log-rank, p = .324). However, after adjusting for covariates, the risk of EC and SC among the individuals with an ED was significantly higher, with adjusted HRs of 5.32 (95% CI: 1.07-26.49, p < .001) and 4.61 (95% CI: 1.91-11.14, p < .001), respectively. EDs were not associated with other cancers. Conclusions:This study provides evidence for the association between EDs and the risk for EC and SC. Further research on mechanisms and prevention is therefore needed.

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Section: Discussionsupporting

confidence: 90%

Section: Comparison Of This Study To Previous Literaturesupporting

confidence: 92%

Section: Study Design and Sampled Participantsmentioning

confidence: 99%

See 1 more Smart Citation

Eating disorders and the risk of esophageal and stomach cancers‐A nationwide, population‐based cohort study in Taiwan

Yeh

Chien

Chung

et al. 2020

Intl J Eating Disorders

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“…Additionally, while the overall census exhibited other temporal-based fluctuations over the course of the year (e.g., based on fiscal quarter or weekday), this observed diurnal pattern persisted throughout and was of greater or equal magnitude. While these other temporal variations have been described in the literature [5][6][7] and are often accounted for in staffing decisions, this is the first study describing the predictable pattern of diurnal census variation on a hospital medicine service. Some of the patterns we observed may be intuitively predictable to clinicians, but may be a surprise to administrators.…”

Section: Discussionmentioning

confidence: 89%

Finding the time: Hourly variation in average daily census on a hospital medicine service

Pierce,

Judson,

Mourad

2023

Journal of Hospital Medicine

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Monitoring the average daily census (ADC) is crucial for managing patient flow and allocating resources. This study analyzed hourly fluctuations in the ADC on a hospital medicine service at an academic medical center. Data from 8342 encounters and 6178 unique patients were collected over a year. The ADC peaked at 11 a.m. (164.1 patients/day) and was lowest at 7 p.m. (155.0 patients/day), accounting for a variation of up to 9.1 patients (5.5% of peak census) depending on the time of day the measurement was taken. Understanding how ADC changes throughout the day will help hospital medicine programs to partner with administrators to optimize resource allocation and staffing. Measuring ADC at midnight, as traditionally done, may underestimate workload and therefore contribute to staffing shortages and physician burnout. Hospitals should consider measuring ADC at its peak, between 7 a.m. and 11 a.m., to ensure adequate staffing and high‐quality patient care.

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“…The current experience of eating disorder symptoms is influenced by the change of seasons [ 1 – 4 ], with a stronger seasonal association of symptom severity and mood in bulimia nervosa than in anorexia nervosa (AN) [ 2 , 5 – 7 ]. Recent preliminary studies suggest a small to medium seasonal association with body mass index (BMI; kg/m 2 ) in patients with AN admitted to inpatient treatment [ 8 , 9 ], indicating that patients who were admitted in the cold season of the year showed a lower BMI at admission compared to patients admitted in the warm season.…”

Section: Introductionmentioning

confidence: 99%

Seasonal variation of BMI at admission in German adolescents with anorexia nervosa

et al. 2018

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ObjectiveRecent preliminary studies indicated a seasonal association of BMI at admission to inpatient treatment for anorexia nervosa (AN), indicating lower BMI in the cold season for restrictive AN. An impaired thermoregulation was proposed as the causal factor, based on findings in animal models of AN. However, findings regarding seasonality of BMI and physical activity levels in the general population indicate lower BMI and higher physical activity in summer than in winter. Therefore, we aimed to thoroughly replicate the findings regarding seasonality of BMI at admission in patients with AN in this study.MethodAN subtype, age- and gender-standardized BMI scores (BMI-SDS) at admission, mean daily sunshine duration and ambient temperature at the residency of 304 adolescent inpatients with AN of the multi-center German AN registry were analyzed.ResultsA main effect of DSM-5 AN subtype was found (F(2,298) = 6.630, p = .002), indicating differences in BMI-SDS at admission between restrictive, binge/purge and subclinical AN. No main effect of season on BMI-SDS at admission was found (F(1,298) = 4.723, p = .025), but an interaction effect of DSM-5 subtype and season was obtained (F(2,298) = 6.625, p = .001). Post-hoc group analyses revealed a lower BMI-SDS in the warm season for restrictive AN with a non-significant small effect size (t(203.16) = 2.140, p = .033; Hedges′g = 0.28). Small correlations of mean ambient temperature (r = −.16) and daily sunshine duration (r = −.22) with BMI-SDS in restrictive AN were found. However, the data were widely scattered.ConclusionsOur findings are contrary to previous studies and question the thermoregulatory hypothesis, indicating that seasonality in AN is more complex and might be subject to other biological or psychological factors, for example physical activity or body dissatisfaction. Our results indicate only a small clinical relevance of seasonal associations of BMI-SDS merely at admission. Longitudinal studies investigating within-subject seasonal changes might be more promising to assess seasonality in AN and of higher clinical relevance.

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Seasonality of hospital admissions and birth dates among inpatients with eating disorders: a nationwide population-based retrospective study

Abstract: Affective psychopathology in inpatients with eating disorders may substantially contribute to symptom severity that waxes and wanes with the seasons. Moreover, the seasonal distribution of birth dates was significantly different in patients without comorbid affective disorders.

Cited by 6 publications

References 33 publications

Eating disorders and the risk of esophageal and stomach cancers‐A nationwide, population‐based cohort study in Taiwan

Eating disorders and the risk of esophageal and stomach cancers‐A nationwide, population‐based cohort study in Taiwan

Finding the time: Hourly variation in average daily census on a hospital medicine service

Seasonal variation of BMI at admission in German adolescents with anorexia nervosa

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