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1.
Pediatr Ann ; 51(4): e150-e153, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1789491

ABSTRACT

Eating disorders can have serious consequences for adolescent patients. Early detection and coordination of treatment can improve outcomes. The coronavirus disease 2019 pandemic has negatively affected mental health, and eating disorders are no exception. The reported increase in eating disorder behaviors and referrals for treatment, combined with the shortage of treatment options, has underscored the role of the outpatient pediatrician. Detection of eating disorders in the primary care setting starts with analyzing vitals and weight trends. If suspecting an eating disorder, one should complete a thorough history with pertinent review of systems, physical examination, and an initial laboratory evaluation. Upon confirming a diagnosis, it is important for a pediatrician to decide on the level of care needed. Given long wait times for treatment centers, utilization of local resources is helpful for coordinating a multidisciplinary approach. Increased funding for eating disorder treatment initiatives could help alleviate the current strain on our health care system. [Pediatr Ann. 2022;51(4):e150-e153.].


Subject(s)
COVID-19 , Feeding and Eating Disorders , Adolescent , COVID-19/diagnosis , COVID-19/therapy , Feeding Behavior , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/therapy , Humans , Mental Health , Pandemics
2.
Am Psychol ; 77(1): 140-142, 2022 01.
Article in English | MEDLINE | ID: covidwho-1768778

ABSTRACT

Eating disorders (EDs) are serious psychiatric disorders that affect 13%-18% of young men and women. EDs are associated with substantial psychiatric and medical morbidity and mortality, indicating a critical need for improved identification and treatment. Despite the relatively high prevalence and severity of EDs, they are often omitted from discussions of mental health. This comment is in response to Gruber et al. (2020), who wrote an important article on the challenges and opportunities facing clinical scientists in the time of COVID-19. Our response extends Gruber et al.'s article by noting additional challenges facing people with an ED during COVID-19 and recognizing opportunities for improved evidence-based assessment and treatment of this important population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
COVID-19 , Feeding and Eating Disorders , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/therapy , Female , Humans , Male , Pandemics , Prevalence , Psychopathology
3.
Int J Environ Res Public Health ; 19(6)2022 03 20.
Article in English | MEDLINE | ID: covidwho-1760612

ABSTRACT

Eating disorders are among the most common clinical manifestations in children, and they are frequently connected with maternal psychopathological risk, internalizing/externalizing problems in children, and poor quality of mother-child feeding exchanges. During the COVID-19 lockdown, in person assessment and intervention were impeded due to the indications of maintaining interpersonal distancing and by limits to travel. Therefore, web-based methods were adopted to meet patients' needs. In this study N = 278 participants completed the SCL-90/R and the CBCL to examine the psychopathological symptoms of mothers and children (age of the children = 24 months); moreover, the dyads were video-recorded during feeding and followed an online video-feedback based intervention. Maternal emotional state, interactive conflict, food refusal in children, and dyadic affective state all improved considerably, as did offspring internalizing/externalizing problems and mothers' depression, anxiety, and obsession-compulsion symptoms. This study showed that video-feedback web-based intervention might be employed successfully to yield considerable beneficial effects.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Internet-Based Intervention , Anxiety Disorders , COVID-19/epidemiology , Child, Preschool , Communicable Disease Control , Feeding and Eating Disorders/therapy , Female , Humans
4.
Obes Surg ; 32(6): 1884-1894, 2022 06.
Article in English | MEDLINE | ID: covidwho-1712330

ABSTRACT

BACKGROUND: Patients undergoing bariatric surgery have high rates of psychiatric comorbidity, which may increase their vulnerability to COVID-19-related mental health distress. Exacerbation of mental health distress and disordered eating could have significant negative effects on long-term weight management and quality of life for these patients if untreated. OBJECTIVE: To determine the efficacy of a telephone-based cognitive behavioral therapy (Tele-CBT) intervention in improving depressive, anxiety, and disordered eating symptoms during COVID-19. METHODS: Participants were recruited as part of a larger randomized controlled trial study (clinicaltrials.gov ID: NCT03315247) between March 2020 and March 2021 and randomized 1:1 to receive Tele-CBT or standard bariatric care. Outcomes of Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Emotional Eating Scale (EES), and Binge Eating Scale (BES) were measured at baseline, immediately post-intervention, and 3 months post-intervention. Linear mixed models were used to test the effect of intervention group, time, and group-by-time interaction for each outcome. RESULTS: Eighty-one patients were included in the intention-to-treat analysis. Mean (SD) age of participants was 47.68 (9.36) years and 80.2% were female. There were significant group-by-time interactions for all outcomes and significant differences between groups across time. There were significant decreases in mean GAD-7 (p = 0.001), PHQ-9 (p < 0.001), EES-Total (p = 0.001), EES-Anger (p = 0.003), EES-Anxiety (p < 0.001), EES-Depression (p < 0.001), and BES (p = 0.002) scores for the Tele-CBT group at post-intervention and follow-up when compared to baseline and the control group. CONCLUSION: Tele-CBT is a feasible and effective treatment for improving psychological distress and disordered eating among post-operative bariatric surgery patients during the COVID-19 pandemic.


Subject(s)
Bariatric Surgery , COVID-19 , Cognitive Behavioral Therapy , Feeding and Eating Disorders , Obesity, Morbid , Bariatric Surgery/methods , Cognitive Behavioral Therapy/methods , Feeding and Eating Disorders/therapy , Female , Humans , Male , Mental Health , Middle Aged , Obesity, Morbid/surgery , Pandemics , Quality of Life , Telephone , Treatment Outcome
5.
Int J Eat Disord ; 55(2): 155-160, 2022 02.
Article in English | MEDLINE | ID: covidwho-1661607

ABSTRACT

The COVID-19 pandemic has profoundly disrupted people's daily life and contributed to adverse health and mental health outcomes. People with pre-existing mental health conditions are particularly likely to experience symptom exacerbation. Complementing the adverse impacts of the pandemic are eating disorder specific risk factors for worsening of eating disorder symptoms and/or impeding treatment progress and recovery. For this joint Virtual Issue, we selected 15 articles that have been published in two leading journals in the field of eating disorders (International Journal of Eating Disorders and Journal of Eating Disorders) to highlight studies that offer information about individuals' lived experience with an eating disorder during the COVID-19 pandemic. In these studies, most participants reported worsening of eating disorder symptoms which they attributed to challenges arising from changes in daily routines including eating and exercise related habits, increased stress, and diminished social contacts. These research findings reported a mixed picture about patients' perceptions of the ease of the transition to virtual delivery of treatment and the quality of care they received during the pandemic. Qualitative studies suggested strategies for supporting people with eating disorders during pandemic conditions, with some of these holding promise for improving care for individuals who experience an eating disorder.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Periodicals as Topic , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/therapy , Humans , Pandemics , SARS-CoV-2
6.
Prim Care Companion CNS Disord ; 24(1)2022 Jan 20.
Article in English | MEDLINE | ID: covidwho-1631300

ABSTRACT

Objective: Recent evidence suggests psychosocial stressors stemming from coronavirus disease 2019 (COVID-19) exposure and public health recommendations and policies have exacerbated eating disorder symptoms. Consequentially, eating disorder acuity has increased during the COVID-19 pandemic. Currently, it is still unclear how the COVID-19 pandemic may be impacting individuals receiving treatment for eating disorders at higher levels of care. The purpose of this study was to examine the impact of COVID-19 on eating disorder symptoms and associated outcomes in a sample of individuals receiving eating disorder treatment compared to individuals receiving treatment in 2019.Methods: Blinded outcomes data from 272 adults who completed treatment at an eating disorder treatment center between April and October of 2019 (pre-COVID-19 group) and 2020 (COVID-19 group) were examined. Repeated measures analyses of variance with Bonferroni correction were used to examine differences in outcome variables and treatment response.Results: Fewer participants reported trauma in 2020, but symptoms were more severe when present. A significant interaction effect for treatment (eg, admission, discharge) and year (eg, pre-COVID-19, COVID-19) was found for eating disorder and trauma symptoms. Moreover, trauma symptom scores were higher in 2020 than in 2019. The interaction among year, trauma, and treatment was significant (F3,268 = 2.11, P = .027, η2 = 0.034), indicating that individuals with severe trauma in 2020 reported less eating disorder symptom score reduction.Conclusions: Results extend understanding of effects during the COVID-19 pandemic on treatment-seeking individuals with eating disorders. Clinical implications suggest that greater attention to trauma when screening eating disorder patients and selecting treatment approaches are needed, particularly during the COVID-19 pandemic.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Adult , Comorbidity , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/therapy , Humans , Pandemics , SARS-CoV-2
7.
Nutrients ; 14(1)2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1580544

ABSTRACT

There are many ways to regulate emotions. People use both adaptive (e.g., regulation by music) and maladaptive (e.g., regulation by food) strategies to do this. We hypothesized that participants with a high level of food-based regulatory strategies and a low level of music-based regulatory strategies (a group with the least adaptive form of emotion regulation) would have significantly greater levels of unhealthy eating behaviours, depression, anxiety and stress, as well as a significantly lower level of healthy eating behaviours than those with a low level of food-based regulatory strategies and a high level of music-based regulatory strategies (a group with the greatest adaptive form of emotion regulation). Participants (N = 410; Mage = 31.77, SD = 13.53) completed: the Brief Music in Mood Regulation Scale, the Emotional Overeating Questionnaire, the Healthy and Unhealthy Eating Behavior Scale, the Depression, Anxiety and Stress Scale and a socio-demographic survey. The four clusters were identified: (a) Cluster 1 (N = 148): low food-based regulatory strategies and high music-based regulatory strategies; (b) Cluster 2 (N = 42): high food-based regulatory strategies and high music-based regulatory strategies; (c) Cluster 3 (N = 70): high food-based regulatory strategies and low music-based regulatory strategies; (d) Cluster 4 (N = 150): low food-based regulatory strategies and low music-based regulatory strategies. Overall, our outcomes partially support our hypothesis, as higher levels of unhealthy eating behaviours, depression, anxiety and stress were observed in participants with high food-based and low music-based regulatory strategies as compared with adults with low food-based and high music-based regulatory strategies. To sum up, the results obtained indicate that during the COVID-19 pandemic the group of people regulating their emotional state and unhealthy eating predominantly with food is potentially characterized by worse functioning than the group of people regulating with music. Therefore, it can be concluded that people who regulate their functioning using food should be included in preventive measures by specialists. During the visit, psychologists and primary care physicians can ask patients about their daily strategies and based on this information specialists can estimate the potential risk of developing high levels of stress and anxiety, depressive disorders and unhealthy eating habits and provide specific (match) intervention.


Subject(s)
Anxiety Disorders/therapy , COVID-19/psychology , Depressive Disorder/therapy , Diet, Healthy/statistics & numerical data , Feeding and Eating Disorders/therapy , Music/psychology , Stress, Psychological/therapy , Adolescent , Adult , Aged , Anxiety Disorders/complications , Anxiety Disorders/psychology , Cluster Analysis , Depressive Disorder/complications , Depressive Disorder/psychology , Emotional Regulation , Feeding and Eating Disorders/complications , Feeding and Eating Disorders/psychology , Female , Humans , Male , Middle Aged , Patient Acuity , SARS-CoV-2 , Stress, Psychological/complications , Stress, Psychological/psychology , Surveys and Questionnaires , Young Adult
8.
Int J Eat Disord ; 55(1): 145-150, 2022 01.
Article in English | MEDLINE | ID: covidwho-1568024

ABSTRACT

OBJECTIVE: Findings show virtual therapy (conducted using internet-based videoconferencing techniques) to be a viable alternative to in-person therapy for a variety of mental-health problems. COVID-19 social-distancing imperatives required us to substitute virtual interventions for in-person sessions routinely offered in our outpatient eating disorder (ED) program-and afforded us an opportunity to compare the two treatment formats for clinical efficacy. METHODS: Using self-report assessments, we compared outcomes in a historical sample of 49 adults with heterogeneous EDs (treated in-person over 10-14 weeks in individual and group therapies) to those of 76 patients receiving comparable virtual treatments, at distance, during the COVID-19 outbreak. Linear mixed models were used to study symptom changes over time and to test for differential effects of treatment modality. RESULTS: Participants in both groups showed similar improvements on eating symptoms, levels of weight gain (in individuals in whom gain was indicated), and satisfaction with services. DISCUSSION: Our results suggest that short-term clinical outcomes with virtual and in-person ED therapies are comparable, and point to potentials of virtual therapy for situations in which geographical distance or other barriers impede physical access to trained therapists or specialized treatments.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Adult , Feeding and Eating Disorders/therapy , Humans , Outpatients , SARS-CoV-2 , Videoconferencing
10.
Psychiatry Res ; 306: 114263, 2021 12.
Article in English | MEDLINE | ID: covidwho-1510207

ABSTRACT

We analyzed service utilization data from the National Eating Disorder Information Centre's (NEDIC) toll-free helpline/chat to assess the impact of the COVID-19 pandemic on help-seeking behaviors among youth with disordered eating and their caregivers. The number of contacts from affected youth (n = 650) and caregivers (n = 823) was significantly higher in the pandemic year than 2018 and 2019. The proportion of affected youth reporting dieting/restriction, perfectionism, and weight pre-occupation was significantly higher during the pandemic than in 2018 and 2019. Our findings lend support to accounts from expert clinicians reporting an increase in youth presenting with eating disordered symptoms during the pandemic.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Help-Seeking Behavior , Adolescent , Caregivers , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/therapy , Humans , Pandemics , SARS-CoV-2
11.
J Am Acad Child Adolesc Psychiatry ; 61(3): 349-350, 2022 03.
Article in English | MEDLINE | ID: covidwho-1509909

ABSTRACT

Since the beginning of the COVID-19 pandemic, our daily lives have changed drastically. The United States has gone through multiple iterations of lockdowns, mandates, and re-openings that have varied throughout the country. The impact of the pandemic on our social, economic, physical, and mental health is still being determined. One area that we are starting to recognize is the impact of the pandemic on eating disorders (ED) in children and adolescents. The treatment of ED has had a long history of treatment barriers that has worsened with the pandemic, making finding care for patients in need significantly more difficult.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Adolescent , Child , Communicable Disease Control , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/therapy , Humans , Pandemics , SARS-CoV-2 , United States/epidemiology
12.
Int J Eat Disord ; 55(1): 3-38, 2022 01.
Article in English | MEDLINE | ID: covidwho-1508643

ABSTRACT

OBJECTIVE: Research investigating the effects of COVID-19 on eating disorders is growing rapidly. A comprehensive evaluation of this literature is needed to identify key findings and evidence gaps to better inform policy decisions related to the management of eating disorders during and after this crisis. We conducted a systematic scoping review synthesizing and appraising this literature. METHOD: Empirical research on COVID-19 impacts on eating disorder severity, prevalence, and demand for treatment was searched. No sample restrictions were applied. Findings (n = 70 studies) were synthesized across six themes: (a) suspected eating disorder cases during COVID-19; (b) perceived pandemic impacts on symptoms; (c) symptom severity pre versus during the pandemic; (d) pandemic-related correlates of symptom severity; (e) impacts on carers/parents; and (f) treatment experiences during COVID-19. RESULTS: Pandemic impacts on rates of probable eating disorders, symptom deterioration, and general mental health varied substantially. Symptom escalation and mental health worsening during-and due to-the pandemic were commonly reported, and those most susceptible included confirmed eating disorder cases, at-risk populations (young women, athletes, parent/carers), and individuals highly anxious or fearful of COVID-19. Evidence emerged for increased demand for specialist eating disorder services during the pandemic. The forced transition to online treatment was challenging for many, yet telehealth alternatives seemed feasible and effective. DISCUSSION: Evidence for COVID-19 effects is mostly limited to participant self-report or retrospective recall, cross-sectional and descriptive studies, and samples of convenience. Several novel pathways for future research that aim to better understand, monitor, and support those negatively affected by the pandemic are formulated.


OBJETIVO: La investigación que se hace sobre los efectos de COVID-19 en los trastornos de la conducta alimentaria está creciendo rápidamente. Se necesita una evaluación exhaustiva de esta literatura para identificar los hallazgos clave y evidenciar las brechas para informar mejor las decisiones de políticas públicas relacionadas con el manejo de los trastornos de la conducta alimentaria durante y después de esta crisis. Se realizó una revisión sistemática del alcance que sintetizó y valoró esta literatura. MÉTODO: Se buscó investigación empírica sobre los impactos de COVID-19 en la gravedad, prevalencia y demanda de tratamiento de los trastornos de la conducta alimentaria. No se aplicaron restricciones a la muestra. Los hallazgos (n = 70 estudios) se sintetizaron en seis temas: (1) casos sospechosos de trastornos de la conducta alimentaria durante COVID-19; (2) impacto percibido en los síntomas; (3) gravedad de los síntomas antes versus durante la pandemia; (4) correlatos relacionados con la pandemia de la gravedad de los síntomas; (5) impactos en los cuidadores/padres; (6) experiencias de tratamiento durante COVID-19. RESULTADOS: El impacto de la pandemia en las tasas de probables trastornos de la conducta alimentaria, deterioro de los síntomas y salud mental en general variaron sustancialmente. La escala de síntomas y el empeoramiento de la salud mental durante y debido a la pandemia fueron reportados comúnmente, y los más susceptibles incluyeron casos confirmados de trastornos de la conducta alimentaria, poblaciones en riesgo (mujeres jóvenes, atletas, padres / cuidadores) e individuos con altos niveles de ansiedad o con miedo de COVID-19. Surgió alguna evidencia de una mayor demanda de servicios especializados en trastornos de la conducta alimentaria durante la pandemia. La transición forzada al tratamiento en línea fue un desafío para muchos, sin embargo, las alternativas de telesalud parecían factibles y efectivas. Conclusiones. La evidencia de los efectos de COVID-19 se limita principalmente al autoinforme de los participantes o al recuerdo retrospectivo, los estudios transversales y descriptivos, y las muestras de conveniencia. Se formulan varias vías novedosas para futuras investigaciones que tienen como objetivo comprender, monitorear y apoyar mejor a aquellos que fueron afectados negativamente por la pandemia.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Cross-Sectional Studies , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/therapy , Female , Humans , Retrospective Studies , SARS-CoV-2
13.
Australas Psychiatry ; 29(5): 561-562, 2021 10.
Article in English | MEDLINE | ID: covidwho-1484246
14.
Curr Psychiatry Rep ; 23(12): 83, 2021 10 21.
Article in English | MEDLINE | ID: covidwho-1482289

ABSTRACT

PURPOSE OF REVIEW: This systematic review aims to collect evidence regarding the impact of the SarsCov-2 pandemic on people affected by eating disorders (EDs) targeting the following variables: psychopathology changes, mechanisms of vulnerability or resilience, and perception of treatment modifications during the pandemic. RECENT FINDINGS: Since the beginning of the pandemic, a mental health deterioration has been detected in the general population and especially in people affected by pre-existing psychiatric conditions. Furthermore, mental healthcare has moved toward online treatment. ED people showed a trend toward worsening of ED-specific psychopathology and impairment in general psychopathology. The most common vulnerability mechanisms were social isolation and feelings of uncertainty, while heightened self-care and reduced social pressure were resilience factors. The online treatment, although raising many concerns related to its quality, was considered the best alternative to the face-to-face approach. These findings may support the idea that stressful events contribute to the exacerbation of ED psychopathology and highlight the relevance of internalizing symptoms in EDs. The identification of putative risk and resilience variables as well as of subjective factors affecting online treatment perception may inform healthcare professionals and may promote more personalized approaches.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/therapy , Humans , Pandemics , Psychopathology , SARS-CoV-2
15.
Curr Opin Psychiatry ; 34(6): 576-583, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1378001

ABSTRACT

PURPOSE OF REVIEW: This review summarizes recent developments in cognitive-behavioural therapy for eating disorders (CBT-ED). More specifically, the past five years were covered, with the latest UK and Dutch guidelines for eating disorders as a starting benchmark, and with special consideration of the past 18 months. RECENT FINDINGS: The new research can be divided into findings that have: (1) reinforced our existing understanding of CBT-ED's models and impact; (2) advanced our understanding and the utility of CBT-ED, including its application for the 'new' disorder Avoidant/Restrictive Food Intake Disorder (ARFID); (3) suggested new directions, which require further exploration in clinical and research terms. These include learning from the circumstances of the COVID-19 pandemic. SUMMARY: CBT-ED has developed substantially in the past 5 years, with consolidation of its existing evidence base, further support for real-life implementation, extension of methods used, and the development of new approaches for working with younger people - particularly in the form of treatments for ARFID. Over the past 18 months, even more promising changes in delivery occurred in response to the COVID19 pandemic, showing that we can adapt our methods in order to work effectively via remote means. Challenges remain regarding poor outcomes for anorexia nervosa.


Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Feeding and Eating Disorders , Feeding and Eating Disorders/therapy , Humans , Pandemics , SARS-CoV-2
16.
J Adolesc Health ; 69(4): 660-663, 2021 10.
Article in English | MEDLINE | ID: covidwho-1307016

ABSTRACT

PURPOSE: The COVID-19 pandemic has led to the development and worsening of eating disorder (ED) symptoms in adolescents and young adults. In order to examine COVID-19-related trends in ED care-seeking at our institution. METHODS: We used interrupted time series regression to examine pre- and postpandemic monthly summary data of the following: (1) ED-related inpatient admissions for medical stabilization; (2) ED-related hospital bed-days; (3) completed outpatient ED assessments; and (4) ED outpatient care-related inquiries at a children's hospital in Boston, MA. RESULTS: Inpatient admissions, hospital bed-days, and outpatient care-related inquiries increased on average over time postpandemic compared to stable volume over time prepandemic (p < .01). Outpatient assessments decreased precipitously initially following COVID-19-related limitations, and rose quickly back to baseline. CONCLUSION: These results indicate increased need for ED-related care during the pandemic. Bolstering resources to meet the needs of these vulnerable patients is critical as the effects of the pandemic continue to be felt.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Adolescent , Child , Emergency Service, Hospital , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/therapy , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , Young Adult
17.
Int J Eat Disord ; 54(9): 1672-1679, 2021 09.
Article in English | MEDLINE | ID: covidwho-1303252

ABSTRACT

INTRODUCTION: Eating disorders (EDs) are serious mental illnesses with high rates of mortality, morbidity, and personal and societal costs. Onset of the Covid-19 pandemic led to increased ED diagnoses in the general public, as well as worsening of ED symptoms in those with an existing ED diagnosis. Heightened prevalence and severity of EDs during the pandemic is complicated by the fact that traditional modes of ED care (specialty intensive treatment provided by a multidisciplinary team) have been difficult to access during the pandemic. METHODS: The current between-groups study (N = 93 ED) tested a multidisciplinary intensive outpatient program (IOP) delivered via in-person (pre-pandemic; n = 60) and virtually via telehealth (during the pandemic; n = 33). RESULTS: We found no differences in outcomes via delivery mode, such that regardless of in-person versus telehealth programming, ED symptoms, depression, and perfectionism significantly decreased and body mass index significantly increased. CONCLUSIONS: Our findings suggest that a multi-disciplinary telehealth ED IOP program is feasible and has comparable outcomes to in-person IOP treatment. These findings have implications for treatment beyond the pandemic, suggesting that adoption of telehealth IOPs is warranted. Such delivery modes of intensive treatments for EDs could be expanded to reach underserved populations, especially in rural areas where treatment is often difficult to access.


Subject(s)
Ambulatory Care , COVID-19 , Feeding and Eating Disorders , Pandemics , Telemedicine , Ambulatory Care/methods , COVID-19/epidemiology , Feeding and Eating Disorders/therapy , Humans , Pilot Projects , Program Evaluation , Telemedicine/organization & administration , Treatment Outcome
18.
Int J Eat Disord ; 54(9): 1689-1695, 2021 09.
Article in English | MEDLINE | ID: covidwho-1286106

ABSTRACT

BACKGROUND: The coronavirus pandemic (COVID-19) has required telehealth to be integrated into the delivery of evidence-based treatments for eating disorders in many services, but the impact of this on patient outcomes is unknown. OBJECTIVE: The present study examined the impact of the first wave of COVID-19 and rapid transition to telehealth on eating disorder symptoms in a routine clinical setting. METHOD: Participants were 25 patients with a confirmed eating disorder diagnosis who had commenced face-to-face treatment and rapidly switched to telehealth during the first wave of COVID-19 in Western Australia. Eating disorder symptoms, clinical impairment and mood were measured prospectively before and during lockdowns imposed due to COVID-19. HYPOTHESES: We predicted that patients would experience poorer treatment outcomes during COVID-19 and would perceive poorer therapeutic alliance and poorer quality of treatment compared to face-to-face therapy. RESULTS: Our hypotheses were not supported. On average, patients achieved large improvements in eating disorder symptoms and mood, and the magnitude of improvement in eating disorder symptoms was comparable to historical benchmarks at the same clinic. Patients rated the quality of treatment and therapeutic alliance highly. DISCUSSION: Providing evidence-based treatment for eating disorders via telehealth during COVID-19 lockdown is acceptable to patients and associated with positive treatment outcomes.


Subject(s)
COVID-19 , Delivery of Health Care, Integrated , Feeding and Eating Disorders , Telemedicine , COVID-19/epidemiology , Feeding and Eating Disorders/therapy , Humans , Telemedicine/organization & administration , Treatment Outcome , Western Australia/epidemiology
20.
BMJ Open Qual ; 10(2)2021 04.
Article in English | MEDLINE | ID: covidwho-1169878

ABSTRACT

BACKGROUND: Mealtimes occur six times a day on eating disorder (ED) inpatient units and are a mainstay of treatment for EDs. However, these are often distressing and anxiety provoking times for patients and staff. A product of patients' distress is an increase in ED behaviours specific to mealtimes. The aim of this quality improvement project was to decrease the number of ED behaviours at mealtimes in the dining room through the implementation of initiatives identified through diagnostic work. METHODS: The Model for Improvement was used as the systematic approach for this project. Baseline assessment included observations in the dining room, gathering of qualitative feedback from staff and patients and the development of an ED behaviours form used by patients and staff. The first change idea of a host role in the dining room was introduced, and the impact was assessed. RESULTS: The introduction of the host role has reduced the average number of ED behaviours per patient in the dining room by 35%. Postintervention feedback demonstrated that the introduction of the host role tackled the disorganisation and chaotic feeling in the dining room which in turn has reduced distress and anxiety for patients and staff. CONCLUSIONS: This paper shows the realities of a quality improvement (QI) project on an ED inpatient unit during the COVID-19 pandemic. The results are positive for changes made; however, a large challenge, as described has been staff engagement.


Subject(s)
COVID-19 , Feeding and Eating Disorders/psychology , Food Service, Hospital/standards , Meals/psychology , Quality Improvement , Adult , Anxiety/psychology , Behavior Observation Techniques , Feeding and Eating Disorders/therapy , Female , Humans , Inpatients/psychology , Male , Personnel, Hospital/psychology , Qualitative Research , SARS-CoV-2 , Stress, Psychological/psychology
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