Lee Janet, Miller David, Rugart Paulina
Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19122, USA.
Children (Basel). 2025 May 31;12(6):730. doi: 10.3390/children12060730.
BACKGROUND/OBJECTIVES: The COVID-19 pandemic has been associated with significant increases in mental-health-related concerns in adolescents, including eating disorders. Disparities in screening, diagnosis, and treatment impact adolescents with eating disorders. This study aimed to describe the patterns in the prevalence and the associations between eating disorder diagnoses and demographic factors in adolescent patients since the start of the COVID-19 pandemic.
We performed a retrospective cohort study examining adolescent patients (aged 12 to 21) with an eating disorder (ED) diagnosis documented between January 2019 and July 2023 using Epic Systems Corporation's Cosmos, a de-identified dataset aggregated from electronic health record (EHR) data. We examined the differences in demographic factors by utilizing chi-square and Kruskal-Wallis rank sum tests.
A total of 82,435 distinct adolescent and young adult patients with eating disorder diagnoses were included in the analytical dataset. The overall prevalence of EDs has increased since 2019. The median age of patients with an ED decreased between 2019 and 2023. There was a decrease in other eating disorder diagnoses and an increase in avoidant-restrictive food intake disorder (ARFID) during the study period. There was a decrease in the proportion of individuals who identified as White and an increase in the proportion of adolescents from historically minoritized racial and ethnic groups (i.e., African American or Black and Hispanic). There was also an increase, during this study period, in the proportion of adolescents with an ED diagnosis who were from more socially vulnerable communities.
Our study describes the changes in the prevalence of sociodemographic factors in adolescent patients with EDs since the start of the COVID-19 pandemic. Further studies should address screening, diagnostic, and treatment barriers for EDs in historically underserved communities.
背景/目的：新冠疫情导致青少年心理健康问题显著增加，其中包括饮食失调。饮食失调的筛查、诊断和治疗方面的差异影响着患有饮食失调症的青少年。本研究旨在描述自新冠疫情开始以来，青少年患者饮食失调诊断的患病率模式以及与人口统计学因素之间的关联。
我们进行了一项回顾性队列研究，使用Epic Systems Corporation的Cosmos（一个从电子健康记录（EHR）数据汇总而来的去识别数据集），检查了2019年1月至2023年7月期间有饮食失调（ED）诊断记录的青少年患者（年龄在12至21岁之间）。我们利用卡方检验和Kruskal-Wallis秩和检验来检查人口统计学因素的差异。
分析数据集中总共纳入了82435名有饮食失调诊断的不同青少年和青年患者。自2019年以来，饮食失调的总体患病率有所上升。2019年至2023年期间，饮食失调患者的中位年龄有所下降。在研究期间，其他饮食失调诊断有所减少，回避性/restrictive食物摄入障碍（ARFID）有所增加。自我认同为白人的个体比例下降，历史上被边缘化的种族和族裔群体（即非裔美国人或黑人以及西班牙裔）的青少年比例增加。在本研究期间，来自社会弱势群体社区且有饮食失调诊断的青少年比例也有所增加。
我们的研究描述了自新冠疫情开始以来，患有饮食失调症的青少年患者社会人口统计学因素患病率的变化。进一步的研究应解决历史上服务不足社区中饮食失调的筛查、诊断和治疗障碍。
