Risk and protective factors for new-onset binge eating, low weight, and self-harm symptoms in >35,000 individuals in the UK during the COVID-19 pandemic

Helena L Davies; Christopher Hübel; Moritz Herle; Saakshi Kakar; Jessica Mundy; Alicia J Peel; Abigail R Ter Kuile; Johan Zvrskovec; Dina Monssen; Kai Xiang Lim; Molly R Davies; Alish B Palmos; Yuhao Lin; Gursharan Kalsi; Henry C Rogers; Shannon Bristow; Kiran Glen; Chelsea Mika Malouf; Emily J Kelly; Kirstin L Purves; Katherine S Young; Matthew Hotopf; Cherie Armour; Andrew M McIntosh; Thalia C Eley; Janet Treasure; Gerome Breen

doi:10.1002/eat.23834

Risk and protective factors for new-onset binge eating, low weight, and self-harm symptoms in >35,000 individuals in the UK during the COVID-19 pandemic

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

OBJECTIVE: The disruption caused by the COVID-19 pandemic has been associated with poor mental health, including increases in eating disorders and self-harm symptoms. We investigated risk and protective factors for the new onset of these symptoms during the pandemic.

METHOD: Data were from the COVID-19 Psychiatry and Neurological Genetics study and the Repeated Assessment of Mental health in Pandemics Study (n = 36,715). Exposures were socio-demographic characteristics, lifetime psychiatric disorder, and COVID-related variables, including SARS-CoV-2 infection/illness with COVID-19. We identified four subsamples of participants without pre-pandemic experience of our outcomes: binge eating (n = 24,211), low weight (n = 24,364), suicidal and/or self-harm ideation (n = 18,040), and self-harm (n = 29,948). Participants reported on our outcomes at frequent intervals (fortnightly to monthly). We fitted multiple logistic regression models to identify factors associated with the new onset of our outcomes.

RESULTS: Within each subsample, new onset was reported by: 21% for binge eating, 10.8% for low weight, 23.5% for suicidal and/or self-harm ideation, and 3.5% for self-harm. Shared risk factors included having a lifetime psychiatric disorder, not being in paid employment, higher pandemic worry scores, and being racially minoritized. Conversely, infection with SARS-CoV-2/illness with COVID-19 was linked to lower odds of binge eating, low weight, and suicidal and/or self-harm ideation.

DISCUSSION: Overall, we detected shared risk factors that may drive the comorbidity between eating disorders and self-harm. Subgroups of individuals with these risk factors may require more frequent monitoring during future pandemics.

PUBLIC SIGNIFICANCE: In a sample of 35,000 UK residents, people who had a psychiatric disorder, identified as being part of a racially minoritized group, were not in paid employment, or were more worried about the pandemic were more likely to experience binge eating, low weight, suicidal and/or self-harm ideation, and self-harm for the first time during the pandemic. People with these risk factors may need particular attention during future pandemics to enable early identification of new psychiatric symptoms.

Original language	English
Journal	The International journal of eating disorders
DOIs	https://doi.org/10.1002/eat.23834 https://doi.org/10.1002/eat.23834
Publication status	E-pub ahead of print - 31 Oct 2022

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@article{cac93f79af024c79b83be562a02a1856,

title = "Risk and protective factors for new-onset binge eating, low weight, and self-harm symptoms in >35,000 individuals in the UK during the COVID-19 pandemic",

abstract = "OBJECTIVE: The disruption caused by the COVID-19 pandemic has been associated with poor mental health, including increases in eating disorders and self-harm symptoms. We investigated risk and protective factors for the new onset of these symptoms during the pandemic.METHOD: Data were from the COVID-19 Psychiatry and Neurological Genetics study and the Repeated Assessment of Mental health in Pandemics Study (n = 36,715). Exposures were socio-demographic characteristics, lifetime psychiatric disorder, and COVID-related variables, including SARS-CoV-2 infection/illness with COVID-19. We identified four subsamples of participants without pre-pandemic experience of our outcomes: binge eating (n = 24,211), low weight (n = 24,364), suicidal and/or self-harm ideation (n = 18,040), and self-harm (n = 29,948). Participants reported on our outcomes at frequent intervals (fortnightly to monthly). We fitted multiple logistic regression models to identify factors associated with the new onset of our outcomes.RESULTS: Within each subsample, new onset was reported by: 21% for binge eating, 10.8% for low weight, 23.5% for suicidal and/or self-harm ideation, and 3.5% for self-harm. Shared risk factors included having a lifetime psychiatric disorder, not being in paid employment, higher pandemic worry scores, and being racially minoritized. Conversely, infection with SARS-CoV-2/illness with COVID-19 was linked to lower odds of binge eating, low weight, and suicidal and/or self-harm ideation.DISCUSSION: Overall, we detected shared risk factors that may drive the comorbidity between eating disorders and self-harm. Subgroups of individuals with these risk factors may require more frequent monitoring during future pandemics.PUBLIC SIGNIFICANCE: In a sample of 35,000 UK residents, people who had a psychiatric disorder, identified as being part of a racially minoritized group, were not in paid employment, or were more worried about the pandemic were more likely to experience binge eating, low weight, suicidal and/or self-harm ideation, and self-harm for the first time during the pandemic. People with these risk factors may need particular attention during future pandemics to enable early identification of new psychiatric symptoms.",

author = "Davies, {Helena L} and Christopher H{\"u}bel and Moritz Herle and Saakshi Kakar and Jessica Mundy and Peel, {Alicia J} and {Ter Kuile}, {Abigail R} and Johan Zvrskovec and Dina Monssen and Lim, {Kai Xiang} and Davies, {Molly R} and Palmos, {Alish B} and Yuhao Lin and Gursharan Kalsi and Rogers, {Henry C} and Shannon Bristow and Kiran Glen and Malouf, {Chelsea Mika} and Kelly, {Emily J} and Purves, {Kirstin L} and Young, {Katherine S} and Matthew Hotopf and Cherie Armour and McIntosh, {Andrew M} and Eley, {Thalia C} and Janet Treasure and Gerome Breen",

note = "Funding Information: This work was supported by the National Institute for Health and Care Research (NIHR) BioResource (RG94028, RG85445), NIHR Biomedical Research Centre (IS‐BRC‐1215‐20018), HSC R&D Division, Public Health Agency (COM/5516/18), MRC Mental Health Data Pathfinder Award (MC_PC_17,217), and the National Centre for Mental Health funding through Health and Care Research Wales. The RAMP study is supported in part by the King's Together Multi and Interdisciplinary Research Scheme (Rapid COVID‐19 call, Round 1; Round 2). Helena Davies and Alicia Peel acknowledge funding from the Economic and Social Research Council (ESRC) as part of a PhD studentship. Dr H{\"u}bel acknowledges funding from Lundbeckfonden (R276‐2018‐4581). Dr Herle is funded by a fellowship from the Medical Research Council UK (MR/T027843/1). Jessica Mundy acknowledges funding from the Lord Leverhulme Charitable Grant. Kai Xiang Lim acknowledges funding from King's International Postgraduate Research Scholarship. The RAMP study is supported in part by the King's Together Multi and Interdisciplinary Research Scheme (Rapid COVID‐19 call, Round 1; Round 2). Dr Young acknowledges funding from MQ; Transforming Mental Health (MQF20/24). Johan Zvrskovec and Abigail ter Kuile acknowledge funding from the National Institute for Health and Care Research (NIHR) Biomedical Research Centre and Guy's and St Thomas' NHS Foundation Trust. Funding Information: Economic and Social Research Council; HSC R&D Division, Public Health Agency, Grant/Award Number: COM/5516/18; King's International Postgraduate Research Scholarship; Lord Leverhulme Charitable Grant; Lundbeckfonden, Grant/Award Number: R276‐2018‐4581; Medical Research Council UK, Grant/Award Number: MR/T027843/1; MQ: Transforming Mental Health, Grant/Award Number: MQF20/24; MRC Mental Health Data Pathfinder Award, Grant/Award Number: MC_PC_17,217; National Institute for Health and Care Research, Grant/Award Numbers: RG85445, RG94028; NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, Grant/Award Number: IS‐BRC‐1215‐20018 Funding information Funding Information: Prof Breen has received honoraria, research or conference grants and consulting fees from Illumina, Otsuka, and COMPASS Pathfinder Ltd. Prof Hotopf is principal investigator of the RADAR‐CNS consortium, an IMI public private partnership, and as such receives research funding from Janssen, UCB, Biogen, Lundbeck and MSD. Prof McIntosh has received research support from Eli Lilly, Janssen, and the Sackler Foundation, and has also received speaker fees from Illumina and Janssen. Funding Information: We thank the GLAD Study, EDGI UK, RAMP Study, and NIHR BioResource volunteers for their participation, and gratefully acknowledge the NIHR BioResource centres, NHS Trusts and staff for their contribution. We thank the National Institute for Health and Care Research, NHS Blood and Transplant, and Health Data Research UK as part of the Digital Innovation Hub Programme. Patient and public involvement groups and services for the RAMP Study were provided by the NIHR KCL‐Maudsley Biomedical Research Centre. This study presents independent research funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Further information can be found at http://brc.slam.nhs.uk/about/core-facilities/bioresource . The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the HSC R&D Division, King's College London, or the Department of Health and Social Care. Publisher Copyright: {\textcopyright} 2022 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.",

year = "2022",

month = oct,

day = "31",

doi = "10.1002/eat.23834",

language = "English",

journal = "The International journal of eating disorders",

issn = "1098-108X",

publisher = "Wiley",

}

TY - JOUR

T1 - Risk and protective factors for new-onset binge eating, low weight, and self-harm symptoms in >35,000 individuals in the UK during the COVID-19 pandemic

AU - Davies, Helena L

AU - Hübel, Christopher

AU - Herle, Moritz

AU - Kakar, Saakshi

AU - Mundy, Jessica

AU - Peel, Alicia J

AU - Ter Kuile, Abigail R

AU - Zvrskovec, Johan

AU - Monssen, Dina

AU - Lim, Kai Xiang

AU - Davies, Molly R

AU - Palmos, Alish B

AU - Lin, Yuhao

AU - Kalsi, Gursharan

AU - Rogers, Henry C

AU - Bristow, Shannon

AU - Glen, Kiran

AU - Malouf, Chelsea Mika

AU - Kelly, Emily J

AU - Purves, Kirstin L

AU - Young, Katherine S

AU - Hotopf, Matthew

AU - Armour, Cherie

AU - McIntosh, Andrew M

AU - Eley, Thalia C

AU - Treasure, Janet

AU - Breen, Gerome

N1 - Funding Information: This work was supported by the National Institute for Health and Care Research (NIHR) BioResource (RG94028, RG85445), NIHR Biomedical Research Centre (IS‐BRC‐1215‐20018), HSC R&D Division, Public Health Agency (COM/5516/18), MRC Mental Health Data Pathfinder Award (MC_PC_17,217), and the National Centre for Mental Health funding through Health and Care Research Wales. The RAMP study is supported in part by the King's Together Multi and Interdisciplinary Research Scheme (Rapid COVID‐19 call, Round 1; Round 2). Helena Davies and Alicia Peel acknowledge funding from the Economic and Social Research Council (ESRC) as part of a PhD studentship. Dr Hübel acknowledges funding from Lundbeckfonden (R276‐2018‐4581). Dr Herle is funded by a fellowship from the Medical Research Council UK (MR/T027843/1). Jessica Mundy acknowledges funding from the Lord Leverhulme Charitable Grant. Kai Xiang Lim acknowledges funding from King's International Postgraduate Research Scholarship. The RAMP study is supported in part by the King's Together Multi and Interdisciplinary Research Scheme (Rapid COVID‐19 call, Round 1; Round 2). Dr Young acknowledges funding from MQ; Transforming Mental Health (MQF20/24). Johan Zvrskovec and Abigail ter Kuile acknowledge funding from the National Institute for Health and Care Research (NIHR) Biomedical Research Centre and Guy's and St Thomas' NHS Foundation Trust. Funding Information: Economic and Social Research Council; HSC R&D Division, Public Health Agency, Grant/Award Number: COM/5516/18; King's International Postgraduate Research Scholarship; Lord Leverhulme Charitable Grant; Lundbeckfonden, Grant/Award Number: R276‐2018‐4581; Medical Research Council UK, Grant/Award Number: MR/T027843/1; MQ: Transforming Mental Health, Grant/Award Number: MQF20/24; MRC Mental Health Data Pathfinder Award, Grant/Award Number: MC_PC_17,217; National Institute for Health and Care Research, Grant/Award Numbers: RG85445, RG94028; NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, Grant/Award Number: IS‐BRC‐1215‐20018 Funding information Funding Information: Prof Breen has received honoraria, research or conference grants and consulting fees from Illumina, Otsuka, and COMPASS Pathfinder Ltd. Prof Hotopf is principal investigator of the RADAR‐CNS consortium, an IMI public private partnership, and as such receives research funding from Janssen, UCB, Biogen, Lundbeck and MSD. Prof McIntosh has received research support from Eli Lilly, Janssen, and the Sackler Foundation, and has also received speaker fees from Illumina and Janssen. Funding Information: We thank the GLAD Study, EDGI UK, RAMP Study, and NIHR BioResource volunteers for their participation, and gratefully acknowledge the NIHR BioResource centres, NHS Trusts and staff for their contribution. We thank the National Institute for Health and Care Research, NHS Blood and Transplant, and Health Data Research UK as part of the Digital Innovation Hub Programme. Patient and public involvement groups and services for the RAMP Study were provided by the NIHR KCL‐Maudsley Biomedical Research Centre. This study presents independent research funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Further information can be found at http://brc.slam.nhs.uk/about/core-facilities/bioresource . The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the HSC R&D Division, King's College London, or the Department of Health and Social Care. Publisher Copyright: © 2022 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.

PY - 2022/10/31

Y1 - 2022/10/31

N2 - OBJECTIVE: The disruption caused by the COVID-19 pandemic has been associated with poor mental health, including increases in eating disorders and self-harm symptoms. We investigated risk and protective factors for the new onset of these symptoms during the pandemic.METHOD: Data were from the COVID-19 Psychiatry and Neurological Genetics study and the Repeated Assessment of Mental health in Pandemics Study (n = 36,715). Exposures were socio-demographic characteristics, lifetime psychiatric disorder, and COVID-related variables, including SARS-CoV-2 infection/illness with COVID-19. We identified four subsamples of participants without pre-pandemic experience of our outcomes: binge eating (n = 24,211), low weight (n = 24,364), suicidal and/or self-harm ideation (n = 18,040), and self-harm (n = 29,948). Participants reported on our outcomes at frequent intervals (fortnightly to monthly). We fitted multiple logistic regression models to identify factors associated with the new onset of our outcomes.RESULTS: Within each subsample, new onset was reported by: 21% for binge eating, 10.8% for low weight, 23.5% for suicidal and/or self-harm ideation, and 3.5% for self-harm. Shared risk factors included having a lifetime psychiatric disorder, not being in paid employment, higher pandemic worry scores, and being racially minoritized. Conversely, infection with SARS-CoV-2/illness with COVID-19 was linked to lower odds of binge eating, low weight, and suicidal and/or self-harm ideation.DISCUSSION: Overall, we detected shared risk factors that may drive the comorbidity between eating disorders and self-harm. Subgroups of individuals with these risk factors may require more frequent monitoring during future pandemics.PUBLIC SIGNIFICANCE: In a sample of 35,000 UK residents, people who had a psychiatric disorder, identified as being part of a racially minoritized group, were not in paid employment, or were more worried about the pandemic were more likely to experience binge eating, low weight, suicidal and/or self-harm ideation, and self-harm for the first time during the pandemic. People with these risk factors may need particular attention during future pandemics to enable early identification of new psychiatric symptoms.

AB - OBJECTIVE: The disruption caused by the COVID-19 pandemic has been associated with poor mental health, including increases in eating disorders and self-harm symptoms. We investigated risk and protective factors for the new onset of these symptoms during the pandemic.METHOD: Data were from the COVID-19 Psychiatry and Neurological Genetics study and the Repeated Assessment of Mental health in Pandemics Study (n = 36,715). Exposures were socio-demographic characteristics, lifetime psychiatric disorder, and COVID-related variables, including SARS-CoV-2 infection/illness with COVID-19. We identified four subsamples of participants without pre-pandemic experience of our outcomes: binge eating (n = 24,211), low weight (n = 24,364), suicidal and/or self-harm ideation (n = 18,040), and self-harm (n = 29,948). Participants reported on our outcomes at frequent intervals (fortnightly to monthly). We fitted multiple logistic regression models to identify factors associated with the new onset of our outcomes.RESULTS: Within each subsample, new onset was reported by: 21% for binge eating, 10.8% for low weight, 23.5% for suicidal and/or self-harm ideation, and 3.5% for self-harm. Shared risk factors included having a lifetime psychiatric disorder, not being in paid employment, higher pandemic worry scores, and being racially minoritized. Conversely, infection with SARS-CoV-2/illness with COVID-19 was linked to lower odds of binge eating, low weight, and suicidal and/or self-harm ideation.DISCUSSION: Overall, we detected shared risk factors that may drive the comorbidity between eating disorders and self-harm. Subgroups of individuals with these risk factors may require more frequent monitoring during future pandemics.PUBLIC SIGNIFICANCE: In a sample of 35,000 UK residents, people who had a psychiatric disorder, identified as being part of a racially minoritized group, were not in paid employment, or were more worried about the pandemic were more likely to experience binge eating, low weight, suicidal and/or self-harm ideation, and self-harm for the first time during the pandemic. People with these risk factors may need particular attention during future pandemics to enable early identification of new psychiatric symptoms.

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U2 - 10.1002/eat.23834

DO - 10.1002/eat.23834

M3 - Article

C2 - 36315390

SN - 1098-108X

JO - The International journal of eating disorders

JF - The International journal of eating disorders

ER -

Risk and protective factors for new-onset binge eating, low weight, and self-harm symptoms in >35,000 individuals in the UK during the COVID-19 pandemic

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