Hospitalizations in adolescents with anorexia nervosa in Spain over two decades

Anorexia nervosa (AN) is a leading mental disorder among adolescents and is associated with impaired physical health and disruption of psychosocial functioning. Knowing the major determinants and trends of AN in youth are critical for earlier diagnosis and prompt interventions.

We retrospectively examined all hospitalizations in Spain with AN among children and adolescents aged 11 to 18 years, using data from the National Registry of Hospital Discharges spanning 2000 to 2021. We adhered to the RECORD guidelines for reporting observational routinely collected health data. All statistical analyses were performed using SPSS v25.0.

Over the 22-year study period, there were 2,015,589 hospitalizations among adolescents in Spain, with 118,609 (5.9%) cases involving mental disorders. There were 15,338 admissions with AN, representing 12.9% of all hospitalizations with mental disorders in youth. Admissions with AN were 5.2-fold more frequent than with bulimia nervosa. Admissions with AN significantly declined from 20.7% in 2000 to 5.2% in 2021. Median age at hospitalizations with AN was 15 years-old. Girls represented 90%. The median length of hospital stay was 14 days. The in-hospital mortality rate was 0.15%, being significantly more frequent in boys than girls. Other mental disorders were present in 15% of AN admissions. After the first year of COVID-19, admissions of adolescents with AN sharply increased by 89%.

AN is an important cause of hospitalization in adolescents with mental disorders in Spain. Girls represent 90% of AN admissions. Whereas the rate of AN hospitalizations declined since year 2000, a surge of admissions in adolescents with AN occurred after the first year of COVID-19. Median age has remained fairly stable around 15-years-old over two decades. Anorexia nervosa (AN) is a leading mental disorder among adolescents. We examined all hospitalizations in adolescents with AN in Spain since year 2000 using a nationwide public database. There were over two million admissions in adolescents during the study period, of which 6% involved mental disorders. AN represented 13% of such cases. Median age at hospitalizations with AN was 15 years-old. Girls represented 90%. Admissions with AN significantly declined over time. However, a sharp increase was noticed after the COVID-19 pandemic. This information may guide educational policies and improve preventive strategies at schools and earlier therapeutic interventions.