Impact of the COVID-19 pandemic on eating disorders diagnoses among adolescents and young adults in Catalonia: A population-based cohort study.

ABSTRACT

OBJECTIVE: To describe the impact of the COVID-19 pandemic on trends in incidence rates (IR) of diagnoses of eating disorders (ED) among adolescents and young adults. METHODS: Population-based cohort study using primary care records of people aged 10-24 years between January, 2016 and December, 2021 in Catalonia, Spain. IRs were calculated monthly and grouped by the different stages of the COVID-19 pandemic in Catalonia (1) the pre-lockdown (January, 2016-February, 2020), (2) lockdown (March-June, 2020) and, (3) post-lockdown (July, 2020-December, 2021) periods. Incidence rate ratios (IRR) relative to the corresponding periods in 2018-2019 were calculated. RESULTS: A total of 1,179,009 individuals were included. The IR was 9.2 per 100,000 person-months (95% confidence intervals [CI] 8.9-9.5) during the pre-lockdown period. It decreased during the lockdown period (6.3 per 100,000 person-months [5.5-7.3]), but substantially increased during the following period (19.4. per 100,000 person-months [18.7-20.1]). While large reductions in IRs were observed for both sexes during the lockdown period (IRR 95% CI 0.65 [0.54-0.78] in females and 0.46 [0.29-0.71] in males), substantial increases during the post-lockdown period were limited to females, and were particularly pronounced among those aged 10-14 and 15-19 years (2.50 [2.23-2.80] and 2.29 [2.07-2.54], respectively). DISCUSSION: The COVID-19 pandemic has resulted in a substantial increase in ED diagnoses, primarily driven by higher rates among adolescent females. PUBLIC SIGNIFICANCE: This population-based cohort study demonstrated a substantial increase in incidence rates of eating disorders in primary care following the end of lockdown in Catalonia, Spain, with adolescent girls seen to be most affected.