Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy of the RWTH University, Aachen, Germany.
Techniker Krankenkasse (Techniker Health Care Service), State Representation North-Rhine-Westphalia, Düsseldorf, Germany.
Eur Psychiatry. 2024 Nov 15;67(1):e77. doi: 10.1192/j.eurpsy.2024.1788.
A large increase in the rate of hospitalizations for adolescents and children with anorexia nervosa (AN) was observed during the coronavirus disease (COVID-19) pandemic. It is still not clear whether this was a temporary effect or whether the increased admission rates persist.
Data were retrieved from the largest health insurance in Germany comprising 2.5 million children between 9 and 19 y. All patients of this age group with a discharge diagnosis of typical (AN) and atypical AN (AAN) according to the International Classification of Diseases, Tenth Revision (ICD-10), were included. Admission rates per 10,000 person-years were computed separately by sex, age and type of AN for entire years from 2019 to 2022 and the first half of 2023 in relation to the entire number of insured persons of the same sex and age per year.
Two years after the final lockdown admission rates were still significantly higher in adolescent and childhood AN than in the pre-COVID-19 time. While admission rates declined for adolescents in 2023, those for children remained high, with an increase for girls of more than 40% compared with the rate before the pandemic (1.42 (CI 1.26, 1.60); < 0.0001). The highest admission risk for AAN relative to the pre-COVID-19 period was observed in adolescents in the first half of 2023 (1.6; CI 1.34; 1.90; < 0.0001).
Children appear to be especially vulnerable to the pandemic-associated disruptions. Clinicians should try to determine the ongoing effects of the pandemic and support early detection and treatment of AN to prevent its often lifelong consequences.
在冠状病毒病（COVID-19）大流行期间，观察到青少年和儿童厌食症（AN）住院率大幅上升。目前尚不清楚这是暂时的影响，还是入院率持续增加。
从德国最大的健康保险公司中检索数据，该保险涵盖了 9 至 19 岁的 250 万儿童。根据国际疾病分类第十版（ICD-10），将该年龄段所有符合典型（AN）和非典型 AN（AAN）出院诊断的患者均纳入研究。按性别、年龄和 AN 类型，分别计算 2019 年至 2022 年全年以及 2023 年上半年每 10,000 人年的入院率，并与每年同性别和年龄的所有参保人数进行比较。
在最后一次封锁结束后的两年，青少年和儿童 AN 的入院率仍明显高于 COVID-19 前时期。虽然 2023 年青少年的入院率有所下降，但儿童的入院率仍然较高，与大流行前相比，女孩的入院率增加了 40%以上（1.42（CI 1.26，1.60）；<0.0001）。与 COVID-19 前时期相比，AAN 的入院风险在 2023 年上半年对青少年最高（1.6（CI 1.34；1.90）；<0.0001）。
儿童似乎特别容易受到与大流行相关的干扰。临床医生应努力确定大流行的持续影响，并支持早期发现和治疗 AN，以防止其经常造成终生后果。
