新型冠状病毒肺炎大流行对厌食症青少年患者和匹配对照者的饮食障碍特征及共病性精神病理学的影响：一项比较队列设计研究。
The implications of the COVID-19 pandemic on eating disorder features and comorbid psychopathology among adolescents with anorexia nervosa and matched controls: a comparative cohort design study.
机构信息
Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands.
Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
出版信息
Eat Weight Disord. 2024 Feb 12;29(1):13. doi: 10.1007/s40519-024-01640-0.
PURPOSE
To examine implications of the COVID-19 pandemic on eating disorder (ED) features and psychopathology in female adolescents with anorexia nervosa (AN).
METHOD
In total 79 females with first-onset AN (aged 12-22 years) were included and were followed up across a period of 1 year. We assessed AN participants recruited pre-pandemic (n = 49) to those recruited peri-pandemic (n = 30). Pre- (n = 37) and peri-pandemic (n = 38) age-, and education-matched typically developing (TD) girls (n = 75) were used as a reference cohort. ED features and psychopathology were assessed at baseline. After 1 year of follow-up the association between pandemic timing and clinical course was assessed. Analyses of covariance were used to examine differences in ED features and psychopathology.
RESULTS
Peri-pandemic AN participants experienced less ED symptoms at baseline compared to pre-pandemic AN participants. In particular, they were less dissatisfied with their body shape, and experienced less interpersonal insecurity. In addition, the peri-pandemic AN group met fewer DSM-IV criteria for comorbid disorders, especially anxiety disorders. In contrast, peri-pandemic AN participants had a smaller BMI increase over time. In TD girls, there were no differences at baseline in ED features and psychopathology between the pre- and peri-pandemic group.
CONCLUSION
Overall, peri-pandemic AN participants were less severely ill, compared to pre-pandemic AN participants, which may be explained by less social pressure and peer contact, and a more protective parenting style during the pandemic. Conversely, peri-pandemic AN participants had a less favorable clinical course, which may be explained by reduced access to health care facilities during the pandemic.
LEVEL OF EVIDENCE
Level III: Evidence obtained from well-designed cohort or case-control analytic studies.
目的
探讨 COVID-19 大流行对厌食症（AN）女性青少年进食障碍（ED）特征和精神病理学的影响。
方法
共纳入 79 例首次发病的 AN 女性（年龄 12-22 岁），并在 1 年的随访期内进行随访。我们评估了大流行前（n=49）和大流行期间（n=30）招募的 AN 参与者。将年龄（n=37）和教育程度（n=38）与 AN 参与者相匹配的典型发育（TD）女孩（n=75）作为参考队列。在基线时评估 ED 特征和精神病理学。在 1 年的随访后，评估了大流行时间与临床病程之间的关系。采用协方差分析比较 ED 特征和精神病理学的差异。
结果
大流行期间 AN 参与者在基线时的 ED 症状较大流行前 AN 参与者少。特别是，她们对体型不满意的程度较低，人际不安的程度较低。此外，大流行期间 AN 组符合 DSM-IV 共病障碍标准的人数较少，尤其是焦虑障碍。相比之下，大流行期间 AN 参与者的 BMI 随时间增加幅度较小。在 TD 女孩中，基线时 ED 特征和精神病理学在大流行前和大流行期间组之间没有差异。
结论
总体而言，与大流行前 AN 参与者相比，大流行期间 AN 参与者的病情较轻，这可能是由于大流行期间社交压力和同伴接触减少，以及更具保护作用的父母教养方式所致。相反，大流行期间 AN 参与者的临床病程较差，这可能是由于大流行期间获得医疗保健设施的机会减少所致。
证据水平
三级：来源于精心设计的队列或病例对照分析研究的证据。
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