Managing Anorexia Nervosa and Other Eating Disorders during COVID-19

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 1101

Special Issue Editors

Prof. Fiona McNicholas
E-Mail Website
Guest Editor
1. Department of Psychiatry, School of Medicine, University College Dublin, Dublin, Ireland
2. Lucena Child and Adolescent Mental Health Service (CAMHS), Dublin, Ireland Department of Psychiatry, Children’s Health Ireland (CHI), Crumlin, Ireland
Interests: child and adolescent psychiatry; eating disorders; burnout; 22q11DS; advocacy
Dr. Siobhán MacHale
E-Mail Website
Guest Editor
1. Department of Psychiatry, Royal College of Surgeons of Ireland, Dublin, Ireland
2. Department of Liaison Psychiatry, Beaumont Hospital, Dublin, Ireland
Interests: liaison psychiatry; anorexia nervosa; self harm

Special Issue Information

Dear Colleagues,

A recent meta-analysis puts the lifetime risk for an eating disorder (ED) in the order of  8.4% for females and 2.2% for males, making it much higher than previously thought. Anorexia nervosa (AN), a complex and multifactorial condition, carries the highest medical and psychiatric risk, with a lifetime prevalence of 1.4% for women and 0.2% for men. Following the onset of the COVID-19 pandemic, rates of disordered eating and eating disorders have been reported to have increased significantly. This has been evident across countries and across services settings, from community to in-patient settings.  Fears were rapidly expressed about the impact and safety of moving to telehealth medicine and psychiatry on eating disorders and the risks of families not being able to access necessary support. Fears were also expressed about the vulnerability of individuals with EDs to infection with COVID-19 and risks of immunological compromise, and these were seen as justifications for minimizing face to face contact and limiting hospitalization. However, as the pandemic persisted and COVID-19 related public health restrictions became much more prolonged than ever initially considered, the ethical aspects of these impacts on a young and vulnerable patient group became an issue for clinical discussion. As we adapt to a post-pandemic world, the further impact on anorexia nervosa presentations is unclear.

The aim of this Special Issue is to provide an overview of the impact of COVID-19 and enforced restrictions on numbers and clinical profiles of those presenting with new or relapsing eating disorders. We welcome papers outlining the lived experience of individuals and families caught up in this period of personal, clinical and service uncertainty.  We are interested to know if fears about increased susceptibility to COVID-19 in those with AN by virtue of malnutrition, immunological compromise and restricted food intake were realized and how this might shed light on the emerging evidence about immunological components being etiologically important in EDs. Given the reported specific increase of AN during the pandemic, the issue has a particular interest in AN, but reports regarding other EDs are also welcome.

We look forward to receiving your contributions that will provide insight into the advances made in our understanding of the etiology and treatment of anorexia nervosa and other EDs during COVID-19.

Prof. Fiona McNicholas
Dr. Siobhán MacHale
Guest Editors

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  • anorexia nervosa
  • eating disorders
  • COVID-19
  • ethics
  • pandemic restrictions

Published Papers (1 paper)

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11 pages, 273 KiB  
The Psychological and Medical Landscape of Anorexia Nervosa over a Decade: A Retrospective Study of Possible Physical and Psychological Shifts
J. Clin. Med. 2023, 12(23), 7294; - 24 Nov 2023
Cited by 2 | Viewed by 931
In recent years, the definition, clinical characteristics, and psychological aspects of anorexia nervosa (AN) have undergone notable changes, influenced by various factors such as biology, psychology, and the environment. The COVID-19 pandemic is one such external factor that has been preliminarily identified as [...] Read more.
In recent years, the definition, clinical characteristics, and psychological aspects of anorexia nervosa (AN) have undergone notable changes, influenced by various factors such as biology, psychology, and the environment. The COVID-19 pandemic is one such external factor that has been preliminarily identified as affecting the clinical presentation of AN. This study specifically aims to assess the alterations in psychological and medical features observed in individuals with AN during the pandemic. This study is a retrospective case review of 252 people diagnosed with AN from two different cohorts: 2010–2012 and 2021. A comparison of psychological and medical data was conducted to identify specific differences in the initial clinical evaluation. Additionally, different effects of the pandemic on age cohorts were assessed, with a focus on distinctions between adolescents and adults. Results revealed that the pandemic cohort had a higher number of new cases, with patients being younger and experiencing more severe psychological symptoms. Hospitalization rates upon first access were also elevated, but no significant differences in medical values were observed. Adolescents during the pandemic showed increased episodes of binge eating, decreased obsessive–compulsive symptoms, and greater difficulty in interoceptive awareness. This study reveals distinct differences in symptomatology among patients, with a particular focus on psychological characteristics such as impulsive behaviors and interoceptive awareness. These behavioral and interoceptive changes could have potential considerations in the treatment pathway. Further investigations are warranted to gain a deeper understanding of the evolving clinical presentation of anorexia nervosa after the pandemic. Full article
(This article belongs to the Special Issue Managing Anorexia Nervosa and Other Eating Disorders during COVID-19)
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