Impact of COVID-19 lockdown in eating disorders: a multicentre collaborative international study

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Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients.
Fondo Investigacion Sanitario-FIS, Grant/Award Numbers: FIS, INT19/00046, PI17/01167; Ministerio de Economia y Competitividad, Grant/Award Number: PSI2015-68701-R; Portuguese Foundation for Science and Technology grant, Grant/Award Number: POCI-01-0145-FEDER-028145; Consejo Nacional de Ciencia y Tecnologia; Generalitat de Catalunya; European Regional Development Fund.
We thank CERCA Programme/Generalitat de Catalunya for institutional support. This manuscript and research was supported by grants from the Department of Health of the Generalitat de Catalunya by the call Pla estratègic de recerca i innovació en salut (PERIS, SLT006/17/00077), the Ministerio de Economía y Competitividad (PSI201568701R), Fondo de Investigación Sanitario (FIS) (INT19/00046, PI17/01167, PI20/132), CIBERINFEC (CB21/13/00009) and co-funded by FEDER funds /European Regional Development Fund (ERDF), a way to build Europe (Eat2beNICE/ H2020-SFS-2016-2; Ref 728018; and PRIME/ H2020-SC1-BHC-2018-2020; Ref: 847879). CIBEROBN, CIBERSAM, CIBERINFEC and CIBERDEM are all initiatives of Instituto de Salud Carlos III (ISCIII). GMB is supported by a postdoctoral grant from FUNCIVA. PPM was supported, in part, by a Portuguese Foundation for Science and Technology grant (POCI-01-0145-FEDER-028145). IB was partially supported by a Post-Residency Grant from the Research Committee of the University
Hospital of Bellvitge (HUB; Barcelona, Spain) 2020–2021. The funders had no role in the study design,
data collection and analysis, decision to publish, or preparation of the manuscript.