104 New Presentations of Anorexia Nervosa and Atypical Anorexia Nervosa In Adolescents During the COVID-19 Pandemic
Notice bibliographique
Résumé
Abstract Primary Subject area Adolescent Medicine Background The coronavirus (COVID-19) pandemic has had profound effects on adolescent mental health. Beginning in mid-March 2020, public health measures were implemented throughout the province of Quebec, including full school closure and confinement. Previous studies have demonstrated the association between stressful events and the exacerbation of anorexia nervosa (AN), however the association of the COVID-19 pandemic on new AN diagnoses remains unknown. Objectives To assess the incidence and severity of newly diagnosed AN or atypical AN (AAN) cases among adolescents during the COVID-19 pandemic compared to the five preceding years. Design/Methods We performed a retrospective analysis from Jan 1 2015 to Nov 15 2020 of new eating disorder assessments at an urban tertiary pediatric hospital. Baseline demographic information and clinical assessment variables were collected. The primary outcomes were the incidence of de novo AN or AAN diagnoses and hospitalization within 7 days of diagnosis. Event rate time trends were compared during the period of pandemic public health measures (March 2020 to November 2020) to the proceeding 5-years (January 2015 to February 2020) using an interrupted time series and logistic mixed modeling. Results Overall, 353 patients met inclusion criteria during the study period. Median patient age was 15.9 (IQR 13.8-16.9) years, 93% were female, and 65% of patients were diagnosed with atypical AN. For the full cohort at diagnosis, %mBMI was 92% (SD ±15%) and mean weight loss was 11 Kg (SD ±7Kg). In the 5 years preceding the pandemic, there were 4.5 new AN/AAN cases per month with a modest downward trend (ßcoeff=-0.016). During confinement, new diagnoses rose to 8.0/month with a steep upward trend (ßcoeff=1.417, p < 0 .001). Similarly, hospitalizations for new cases increased from 0.8 to 2.6/month with a significant increase in linear tend (ßcoeff -0.012 vs. 0.500, p < 0 .001). Moreover, patients diagnosed during COVID-19 confinement had a shorter duration of symptoms (6 months vs. 10 months, p=0.001), with a higher percentage of body weight loss (19% vs. 16%, p=0.03) at a faster rate (2.3kg/mo vs. 1.5Kg/mo, p=0.001). Bradycardia was more pronounced at diagnosis during the pandemic (55 bpm vs. 62 bpm, p=0.001) with a greater proportion meeting threshold for admission (38% vs. 19%, p=0.001). Conclusion During the COVID-19 confinement, new diagnoses of AN and AAN nearly doubled and hospitalizations for these patients more than tripled. Markers for disease severity were more pronounced and evolved more rapidly. Findings highlight the urgent need for increased community resources during the pandemic, as well as prospective research to understand drivers and prognosis for these patients more effectively.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».