Impact of the COVID-19 pandemic, lockdown and social restrictions on eating disorders in adolescents in Girona: before-and-after observational study

Abstract

BACKGROUND: Eating disorders (ED) are severe mental illnesses with a significant rate of mortality and complications. These disorders usually affect adolescents, who are in a period that can be considered vulnerable due to the physical, emotional and hormonal changes to which they are exposed. The cause of eating disorders is believed to be multifactorial with many risk factors that can precipitate, trigger or sustain the illness. One of the most important factors is the sociocultural factor, in which the environment and surroundings play an essential role. The appearance of the coronavirus pandemic has affected in many aspects the normal functioning of society at economic, health and emotional levels. Not only because of the situation of fear and stress that it may cause, but also because social restrictions and distancing measures have modified some lifestyles. This situation could have been a risk factor for the emergence or worsening of eating disorders in the population at risk. Therefore, it is interesting to study what impact the coronavirus pandemic has had on these disorders in the adolescent population. HYPOTHESIS: The COVID-19 pandemic, lockdown and social restrictions have increased the incidence of ED in the adolescent population of Girona and have caused an exacerbation of these disorders in the adolescents already diagnosed based on the number of hospitalizations. OBJECTIVES: The main aim of this study is to analyze the impact of the COVID-19 pandemic, lockdown and social restrictions on the incidence of eating disorders in the adolescent population of Girona. The secondary objective is to analyze the impact on the adolescents already diagnosed by measuring the increase in hospitalizations to see if there has been an exacerbation of the disease. Further, the results will be analyzed according to gender, age and type of eating disorder (anorexia nervosa, bulimia nervosa or binge eating disorder). METHODS: A before-and-after observational study will be performed using clinical health records from the Xarxa de Salut Mental (XSM) of the sanitary region of Girona. The sample will

be selected from the adolescent population between 12 and 18 years old of Girona with a non- probabilistic convenience method. The incidence and the number of hospitalizations during the

pandemic (pandemic period) will be compared with the last 3 years (pre-pandemic period). The results will be compared according to the covariates of the study: age, gender and type of eating disorder