Tag Archives: disorders

Cases of eating disorders have doubled in the US during the pandemic

The number of hospitalizations for health disorders has doubled across the US during the pandemic (between January 2018 and December 2020), according to new research. The largest part of this increase was represented by cases of anorexia or bulimia.

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Despite this, other common behavioral health conditions such as depression, alcohol use, or opioid use disorder, haven’t registered any meaningful changes during this time.

Eating issues

“This pandemic era is going to have some long-term impacts on the course of disease and the course of weight over the lifespan,” says Kelly Alison, Ph.D., Director of the Center for Weight and Eating Disorders at the University of Pennsylvania, co-author of the paper. “What that does for eating disorders? We just don’t know.”

Although the team can’t yet tell what the cause of this increase is, they believe that we’re looking at the combined effect of several factors ranging from the toll the pandemic has taken on our mental health, an outsized focus on weight gain in parallel with constantly viewing ourselves on video calls, and even symptoms of COVID-19 itself. There is also very little data on how this trend will affect public health in the long run.

The study included data from over 3.2 million individuals across the U.S., with a mean age of 37.7 years old. According to the findings, the number of inpatient care cases for eating disorders remained pretty stable over time, at approximately 0.3 cases per 100,000 people per month, until May 2020. At that date, the number of cases doubled, to 0.6 per 100,000. This increase was registered across anorexia nervosa, bulimia nervosa, and other and unspecified eating disorders.

The average length of inpatient stays for such cases has also increased. This was on average 9 days and 8 days between June to December of 2018 and 2019, respectively, going up to 12 days between June and December of 2020. A similar increase was not seen for the 3 behavioral health conditions used as controls over the same timeframe.

As far as outpatient care cases for eating disorders have increased from around 25 per 100,000 people per month to 29 per 100,000. The age range of inpatient patients ranged from 12 to 20 pre-pandemic, rising to 18 to 28 after its onset.

The average length of inpatient stays for such cases has also increased. This was on average 9 days and 8 days between June to December of 2018 and 2019, respectively, going up to 12 days between June and December of 2020. A similar increase was not seen for the 3 behavioral health conditions used as controls over the same timeframe.

Stress caused by the pandemic and the changes it caused in our lives could be one of the drivers of this increase, the team reports. Additionally, the shift towards video calls for conferences at work gives us ample opportunity to look at ourselves, which can create a further drive towards the development of eating disorders.

“During the pandemic, having a lack of routine and structure primed us in terms of our behaviors around food,” says Ariana Chao, Ph.D., from Penn’s School of Nursing.

Social media reflects this increase in self-scrutiny and concerns regarding weight, the authors report. As far as eating disorders are concerned, discussions about weight can be “very triggering”, Allison explains, so social media can create a lot of stress in patients at risk. Different people handle this stress differently, the team adds, with some binge eating, while others didn’t eat enough.

For now, it’s not clear whether the rising trend in eating disorder cases will continue after the pandemic. The present study is based on data up to December 2020, so it’s missing the latest part of the picture. The team is now hard at work analyzing data recorded well into 2021 to see how these trends are evolving.

“We really need more research,” says Chao. “Adversity can be a long-term predictor of developing eating disorders. Even the transition back to ‘normal’ can exacerbate eating disorders. Everything is changing so rapidly. Then again, people are also resilient. It’s hard to say what the long-term implications will be.”

The paper “Trends in US Patients Receiving Care for Eating Disorders and Other Common Behavioral Health Conditions Before and During the COVID-19 Pandemic” has been published in the journal JAMA Network Open Psychiatry.

Researchers hone in on potential antibodies against OCD, maybe other mental disorders too

Researchers at the Queen Mary University of London and the University of Roehampton, London report finding a potential antibody treatment against obsessive compulsive disorder (OCD) — in mice.

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The team reports that human patients suffering from OCD show increased levels of a protein called Immuno-moodulin (Imood) in lymphocytes, a type of immune cell. Mice whose lymphocytes were modified to show the same high levels of Imood showed behaviors that are characteristic of anxiety and stress, such as digging and excessive grooming, which are related to OCD.

However, the team also showed that an antibody can be used to neutralize the protein, which reduced the animals’ apparent anxiety levels in lab tests. The findings might help us develop a similar treatment for humans.

There’s a pill for that

“There is mounting evidence that the immune system plays an important role in mental disorders,” said Professor Fulvio D’Acquisto, a professor of immunology at the University of Roehampton and honorary professor of Immunopharmacology at Queen Mary University of London, who led the research. “And in fact people with auto-immune diseases are known to have higher than average rates of mental health disorders such as anxiety, depression and OCD.”

“Our findings overturn a lot of the conventional thinking about mental health disorders being solely caused by the central nervous system.”

Professor D’Acquisto first identified Imood by chance while studying a different protein (Annexin-A1) and the role it plays in autoimmune diseases such as multiple sclerosis and lupus. As part of the study, he engineered lab mice to overexpress this protein in their immune cells in the hopes of inducing autoimmune diseases in the animals and found that the mice were more anxious than normal. Upon closer inspection, the team found that one protein was especially active and likely protected the animals from such diseases.

Curious about its effects, the team administered an antibody treatment to the mice that would block the Imood gene — and their behavior returned to normal within a couple of days. This led the team to christen the gene encoding it “Immuno-moodulin”.

Later on, the team tested the immune cells of 23 patients with OCD and 20 healthy volunteers to check if they showed any differences in Imood levels. OCD patients had around six times higher expression of these genes than the controls. Together with previous findings, the team is confident that this showcases the role this protein has in mental health disorders such as OCD or ADHD (Attention-Deficit/Hyperactivity Disorder).

The team believes that the gene encoding the protein doesn’t directly influence brain functions, but that its activity is tied to that of other genes in brain cells that are linked to disorders like OCD.

“This is work we still have to do to understand the role of Imood,” says Professor D’Acquisto. “We also want to do more work with larger samples of patients to see if we can replicate what we saw in the small number we looked at in our study.”

“It is early still, but the discovery of antibodies — instead of the classical chemical drugs — for the treatment of mental disorders could radically change the life of these patients as we foresee a reduced chance of side effects,” he adds.

The team is collaborating with the biopharmaceutical company UCB to develop antibodies against Imood that can be used in humans and to understand how this could be used to treat patients with mental disorders. Professor D’Acquisto estimates it could take up to five years before a treatment is ready for clinical trials.

The paper “Immuno-moodulin: A new anxiogenic factor produced by Annexin-A1 transgenic autoimmune-prone T cells” has been published in the journal Brain, Behavior, and Immunity.