Leickert Jule, Zillmer Stephan, Bachmann Christian J, Vivirito Annika, Enders Dirk, Pintsch Josephine, Correll Christoph U, Jaite Charlotte
Department of Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Hildesheim, Universitätsplatz 1, 31141, Hildesheim, Germany.
Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt Universitaet Zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Eat Weight Disord. 2025 Mar 21;30(1):30. doi: 10.1007/s40519-025-01738-z.
The aim of this study was to analyze data of children and adolescents in Germany insured according to legal requirements (statutorily insured) regarding epidemiology, comorbidities, and care of bulimia nervosa (BN) pre- vs. intra-COVID-19 pandemic.
The study is based on anonymized claims data of 10-17.9 years old children and adolescents statutorily insured in Germany from the InGef Berlin GmbH research database. The database combines data of more than 50 statutory health insurances and is representative of the German population. Prevalence, (quarterly) incidence, comorbidities and in- and outpatient treatment of BN (ICD-10: F50.2/F50.3) pre-COVID (01/2018-03/2020; N = 282,711) vs. intra-COVID (04/2020-12/2021; N = 282,738) was compared using descriptives and χ tests, Welch-tests and interrupted time series analysis. The analysis was stratified by age groups (children: 10-13 years; adolescents: 14-17 years).
Prevalence of BN was 0.09% pre-COVID and 0.07% intra-COVID (OR = 0.78 [0.65, 0.93]). After pandemic onset, a positive trend in the quarterly incidence among adolescents was observed (p = .016). Outpatient visits to general practitioners decreased (OR = 0.59 [0.35, 0.98]).
The observed decline in diagnosed and treated BN cases and the positive trend in quarterly incidence could be attributed to an increase in unregistered cases due to the overburdened care situation that emerged with the onset of the COVID-19 pandemic. Researchers and healthcare providers need to be aware of the potential for a backlash and deterioration/chronification of BN symptoms in children and adolescents. Level of evidence No level of evidence.
本研究旨在分析德国法定参保（法定投保）的儿童和青少年在新冠疫情前与疫情期间关于神经性贪食症（BN）的流行病学、合并症及护理的数据。
该研究基于德国柏林InGef GmbH研究数据库中10至17.9岁法定参保儿童和青少年的匿名理赔数据。该数据库整合了50多家法定健康保险的数据，具有德国人口代表性。比较了新冠疫情前（2018年1月至2020年3月；N = 282,711）与疫情期间（2020年4月至2021年12月；N = 282,738）BN（国际疾病分类第十版：F50.2/F50.3）的患病率、（季度）发病率、合并症以及门诊和住院治疗情况，采用描述性统计、χ检验、韦尔奇检验和中断时间序列分析。分析按年龄组分层（儿童：10至13岁；青少年：14至17岁）。
BN的患病率在新冠疫情前为0.09%，疫情期间为0.07%（比值比 = 0.78 [0.65, 0.93]）。疫情开始后，青少年的季度发病率呈上升趋势（p = 0.016）。全科医生的门诊就诊次数减少（比值比 = 0.59 [0.35, 0.98]）。
观察到的确诊和治疗的BN病例减少以及季度发病率上升趋势，可能归因于新冠疫情爆发后护理负担过重导致未登记病例增加。研究人员和医疗服务提供者需要意识到儿童和青少年中BN症状反弹及恶化/慢性化的可能性。证据水平 无证据水平。
