Abstract
BackgroundLockdown implemented to prevent the COVID-19 spread resulted in marked changes in the lifestyle. The objective of the current study was to assess the impact of lockdown measures on a cohort of eating disorder (ED) patients being followed as part of an ongoing naturalistic treatment study.MethodsNinety-nine patients aged 18 or older, currently or previously, in treatment at a Portuguese specialized hospital unit were contacted by phone and invited to participate in the current survey. Fifty-nine agreed to be interviewed by phone, and 43 agreed to respond to a set of self-report measures of ED symptoms, emotion regulation difficulties, clinical impairment, negative urgency, and COVID-19 impact, during the week after the end of the lockdown period.ResultsData showed that of the 26 patients currently in treatment: 8 remained unchanged (31%), 7 deteriorated (27%), and 11 reliably improved (42%). Of the 17 participants not currently in treatment: 3 deteriorated (18%), 9 remained unchanged (53%), and 5 (29%) improved after the lockdown period. The Coronavirus Impact Scale showed that most patients considered their routines moderately or extremely impacted, experienced stress related to coronavirus, and showed difficulty in maintaining physical exercise and feeding routines. Results suggest that higher impact of COVID-19 lockdown was significantly correlated with eating disorder symptoms and associated psychopathology, impulsivity, difficulties in emotion regulation and clinical impairment measured at post-lockdown. In addition, the impact of COVID-19 and lockdown measures on clinical impairment was mediated by difficulties in emotion regulation.ConclusionsFindings suggest that some ED patients may experience worsening of their condition, especially if associated with difficulties in emotion regulation, and these difficulties might be exacerbated in the context of a stressful crisis and lockdown measures, highlighting the need for intervention strategies to mitigate its negative impact.
Highlights
Lockdown implemented to prevent the COVID-19 spread resulted in marked changes in the lifestyle
Plain English summary The current study assessed the impact of the COVID-19 pandemic crisis and the government implemented lockdown measures on a group of patients diagnosed with eating disorders, attending a specialized treatment center in Portugal
We found that those struggling with eating disorders may experience worsening of their condition, especially if they tend to have difficulties in emotion regulation, and their living routines and access to care are disrupted
Summary
Lockdown implemented to prevent the COVID-19 spread resulted in marked changes in the lifestyle. Rodgers and colleagues [4] proposed three pathways by which the COVID-19 pandemic might cause ED symptomatic exacerbation: 1) disruptions of daily routines, and constrains in outdoors, and social activities, that are useful in terms of emotional regulation; 2) exposure to ED-specific and anxiety-provoking media content; and 3) emotional distress caused by fears of contagion and increased health concerns. The combination of these pathways to increased risk combined with a potential lack of availability of protective factors, like social support and access to care have the potential to affect in a unique way people with eating disorders. Lack of in-person social contact, and confinement to own home may increase negative affect, that associated with difficulties in emotional regulation might pose specific challenges to people with eating disorders
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