Department of Social and Preventive Medicine, Université de Montréal School of Public Health, Montreal, QC, Canada.
Sainte-Justine University Hospital Research Centre, Montreal, QC, Canada.
Can J Public Health. 2023 Feb;114(1):22-32. doi: 10.17269/s41997-022-00715-8. Epub 2022 Dec 8.
OBJECTIVES: The COVID-19 pandemic has been associated with increased mental health problems. We investigated (1) associations between disordered eating in adolescence and mental health problems after one year of the pandemic and (2) the mechanisms explaining associations. METHOD: We analyzed data from a population-based birth cohort in Quebec, Canada (557 males and 759 females). High and low levels of disordered eating symptom trajectories were previously estimated (age 12, 15, 17, and 20 years). Anxiety, depression, non-suicidal self-injury, and suicidal ideation were assessed at 23 years (March-June 2021). Putative mediators included loneliness and social media use (age 22 years, July-August 2020). Analyses controlled for mental health and socio-economic status at age 10-12 years and were conducted for males and females separately. RESULTS: Females in the high-level disordered eating symptom trajectory were at increased risk for non-suicidal self-injury (OR 1.60; 95% CI 1.02-2.52) and suicidal ideation (2.16; 1.31-3.57), whereas males were at increased risk for severe anxiety (2.49; CI 1.11-5.58). Males and females in the high-level trajectory were more likely to report severe depression (2.26; 1.14-5.92 and 2.15, 1.36-3.38 respectively). Among females, associations were partially explained (17-35%) by loneliness during the first 4 months of the pandemic. CONCLUSION: Young adults who experienced disordered eating as adolescents were at increased risk of mental health problems during the pandemic. Loneliness partially mediated the effect, suggesting that pandemic mitigation resulting in increased social isolation may have exacerbated mental health problems among women with a history of disordered eating.
目的:新冠疫情与心理健康问题的增加有关。我们研究了(1)青少年饮食失调与疫情一年后心理健康问题之间的关联,以及(2)解释关联的机制。
方法:我们分析了加拿大魁北克基于人群的出生队列的数据(557 名男性和 759 名女性)。此前已经估计了饮食失调症状轨迹的高低水平(12、15、17 和 20 岁)。23 岁(2021 年 3 月至 6 月)评估了焦虑、抑郁、非自杀性自伤和自杀意念。假定的中介因素包括孤独感和社交媒体使用(2020 年 7 月至 8 月,22 岁)。分析控制了 10-12 岁时的心理健康和社会经济地位,并分别对男性和女性进行了分析。
结果:高水平饮食失调症状轨迹的女性发生非自杀性自伤的风险增加(OR 1.60;95%CI 1.02-2.52)和自杀意念(2.16;1.31-3.57),而男性发生严重焦虑的风险增加(2.49;CI 1.11-5.58)。高水平轨迹的男性和女性更有可能报告严重抑郁(2.26;1.14-5.92 和 2.15,1.36-3.38)。在女性中,孤独感在疫情前 4 个月部分解释了(17-35%)关联。
结论:青少年时期经历饮食失调的年轻人在疫情期间更有可能出现心理健康问题。孤独感部分解释了这种影响,表明缓解大流行导致社交隔离增加,可能加剧了有饮食失调史的女性的心理健康问题。
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