Suicidal Behaviour in Adolescents With Eating Disorders: A Pandemic Timeline Comparison.

Area of Science:

• Psychiatry
• Adolescent Health
• Mental Health

Background:

• The COVID-19 pandemic has had profound effects on global mental health.
• Adolescents with eating disorders (EDs) may be particularly vulnerable to pandemic-related stressors.
• Understanding the pandemic's impact on suicide attempts (SA), suicide ideation (SI), and self-harm behaviors (SHB) in this population is crucial.

Purpose of the Study:

• To investigate the longitudinal impact of the COVID-19 pandemic on SA, SI, and SHB in adolescents with EDs.
• To compare these behaviors across four pandemic phases: pre-pandemic, early, middle, and late.

Main Methods:

• Retrospective assessment of SA, SI, and SHB using the HEEADSSS instrument.
• Participants (n=403) were categorized into four time periods based on clinic visits: pre-pandemic (T0), early (T1), middle (T2), and late (T3) pandemic.
• Statistical analysis compared behavior prevalence across the defined pandemic phases.

Main Results:

• Overall, 27.8% reported SHB, 34% reported SI, and 10.2% reported SA.
• SHB and SI significantly increased during the pandemic (T1+T2+T3 vs. T0, p<0.001), with the highest increases observed in T2 and T3.
• SA did not significantly change (p=0.124). SHB increased across all ED subgroups, and SI notably rose in the bulimia nervosa (BN) group (p=0.015).

Conclusions:

• The COVID-19 pandemic is associated with increased SI and SHB among adolescents with EDs.
• These increases were most pronounced during the middle and late phases of the pandemic.
• Healthcare providers must recognize the potential long-term mental health consequences of the pandemic on this vulnerable group.