2019冠状病毒病与饮食失调及饮食失调患者的心理健康问题
COVID-19 and eating disorder and mental health concerns in patients with eating disorders.
作者信息
Vitagliano Julia A, Jhe Grace, Milliren Carly E, Lin Jessica A, Spigel Rebecca, Freizinger Melissa, Woods Elizabeth R, Forman Sara F, Richmond Tracy K
机构信息
Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA.
Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, 02115, MA, USA.
出版信息
J Eat Disord. 2021 Jul 2;9(1):80. doi: 10.1186/s40337-021-00437-1.
BACKGROUND
The Coronavirus (COVID-19) pandemic dramatically transformed daily life for adolescents and young adults, altering social and physical environments. Previous research has shown such shifts in daily life to be especially challenging for people living with eating disorders (ED). However, the extent of this environmental change on ED symptoms and mental health (MH) has been relatively unexplored in patients with EDs. This study examines how young people with EDs feel the COVID-19 pandemic has affected their living environments as well as their ED and MH symptoms and motivation for ED recovery.
METHODS
Participants were enrollees in the Registry of Eating Disorders and their Co-morbidities OVER time in Youth (RECOVERY) who responded to an additional survey (n = 89) in July 2020 to assess their perceptions of the impact of the COVID-19 pandemic. Participants reported on concerns of their ED worsening due to increased time living in a "triggering environment" due to the pandemic as well as perceived COVID-related changes in intrusive ED thoughts, depression, anxiety, isolation, and motivation to recover. Logistic regression models, adjusted for age and ED diagnosis, examined the association of triggering environment with ED and MH symptoms.
RESULTS
The majority of respondents reported concern for worsening of their ED due to a "triggering environment" (63%). Most reported an increase in ED thoughts (74%), feelings of anxiety (77%), depression (73%), and isolation (80%) they perceived to be related to the pandemic. Nearly one-third reported decrease in motivation to recover (29%) they perceived to be related to the pandemic. After adjusting for age and ED diagnosis, participants who reported concern for worsening of their ED due to a triggering environment had nearly 18 times the odds of decreased motivation to recover (OR 18.1; 95% CI 3.37-97.4, p = 0.003) and nearly 24 times the odds of increased ED thoughts (OR 23.8; 95% CI 4.31-131.6, p < 0.001) compared to those who did not report concern for worsening of their ED due to a triggering environment.
CONCLUSIONS
Our findings demonstrate the perceived negative impact the COVID-19 pandemic has had on the self-reported ED and MH symptoms in patients with EDs, particularly in those who report concern for a negative environmental change. These results underscore the need for heightened monitoring of patients with EDs during the pandemic.
背景
冠状病毒病（COVID-19）大流行极大地改变了青少年和年轻人的日常生活，改变了社会和物理环境。先前的研究表明，这种日常生活的变化对患有饮食失调症（ED）的人来说尤其具有挑战性。然而，这种环境变化对饮食失调症患者的症状和心理健康（MH）的影响程度相对未被探索。本研究调查了患有饮食失调症的年轻人如何感受COVID-19大流行对他们生活环境的影响，以及对他们的饮食失调症、心理健康症状和饮食失调症康复动机的影响。
方法
参与者是饮食失调及其共病随时间变化青年登记处（RECOVERY）的登记人员，他们在2020年7月回复了一项额外调查（n = 89），以评估他们对COVID-19大流行影响的看法。参与者报告了由于大流行导致在“触发环境”中生活时间增加而担心饮食失调症恶化，以及与COVID相关的侵入性饮食失调想法、抑郁、焦虑、孤独感和康复动机的感知变化。在对年龄和饮食失调症诊断进行调整的逻辑回归模型中，研究了触发环境与饮食失调症和心理健康症状之间的关联。
结果
大多数受访者报告担心由于“触发环境”导致饮食失调症恶化（63%）。大多数人报告饮食失调想法增加（74%）、焦虑感增加（77%）、抑郁感增加（73%）以及孤独感增加（80%），他们认为这些与大流行有关。近三分之一的人报告康复动机下降（29%），他们认为这与大流行有关。在对年龄和饮食失调症诊断进行调整后，那些报告由于触发环境而担心饮食失调症恶化的参与者康复动机下降的几率几乎是未报告者的18倍（比值比18.1；95%置信区间3.37 - 97.4，p = 0.003），饮食失调想法增加的几率几乎是未报告者的24倍（比值比23.8；95%置信区间4.31 - 131.6，p < 0.001）。
结论
我们的研究结果表明，COVID-19大流行对饮食失调症患者自我报告的饮食失调症和心理健康症状产生了负面影响，特别是在那些报告担心负面环境变化的患者中。这些结果强调了在大流行期间加强对饮食失调症患者监测的必要性。
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