Background: Concern has been expressed about an increase in mental illness and eating disorders in particular during the pandemic. Whether Covid-19 associated stress presents a specific risk for eating disorders, new or relapsing, in vulnerable groups remains to be established. Aim: This study explores any impact of Covid-19 on numbers and clinical profile of eating disorder presentations to a Child and Adolescent Mental Health Service (CAMHS) specialist eating disorder treatment program pre and during Covid-19. Methods: Following ethical approval, retrospective data extraction from electronic healthcare records from all referrals to a CAMHS specialist eating disorder treatment program in Dublin, Ireland was conducted. The study period covered 42months, from 1st January 2018 until 31st Aug 2021. Referral rates and clinical characteristics of pre- Covid-19 (January 2018-Feb 2020) and Covid-19 patients (March 2020-Aug 2021) were examined, using Welch’s t- and chi-square tests for continuous and categorical data respectively. Results: 128 youth were assessed over the 42-month study period, with significantly higher rates of referrals post-pandemic (3.78 per month compared to a pre- Covid-19 rate of 2.31/month). (p=.02). Youth referred during Covid-19 lost weight at a faster rate; 2.3kg/month compared to 1.9kg/month pre- Covid-19 (p=.39) and showed a higher rate of % Ideal bodyweight loss (IBW), 4.8% IBW/month compared to 2.6% IBW/month pre- Covid-19 (p=<.001). They also had a shorter duration of illness pre-referral (M=7.4 months, SD=3 pre-Covid-19; M=4.8 months, SD=4.5 post Covid-19, (p<.001), with fewer youth (19%) prescribed psychotropic medication than pre Covid-19 (43%, p=.011). Many youth (80%) self-declared Covid-19 as having had an adverse effect on their overall well-being and as a contributory factor to the development of their eating disordered pathology.Conclusions: This study supports the growing consensus of a Covid-19 specific impact for ED services with higher rates of referrals, youth presenting with a faster pace of IBW% loss and earlier referral to specialist services. Whether this reflects a true and specific increase in EDs or reflects an overall increase in CAMHS referrals, with increased transfer to ED services, needs further examination.
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