Abstract
Background
Self-harm and eating disorders share multiple risk factors, with onset typically occurring during adolescence or early adulthood. We examined incidence rates among young people in the UK in the two years following the onset of the COVID-19 pandemic.
Methods
We conducted a population-based investigation of the primary care electronic health records of patients aged 10-24 years in the UK Clinical Practice Research Datalink (CPRD). Monthly incidence rates of eating disorders and self-harm, January 2010 through March 2022, were calculated. Based on antecedent trends, negative binomial regression models were fitted to predict rates after the pandemic began in March 2020. Percentage differences between observed and predicted rates were calculated to indicate changes following the onset of the pandemic.
Findings
Substantial increases in incidence of both outcomes were observed among young females since the onset of the pandemic. Incidence of eating disorder during the pandemic was 42·3% (95% CI 25·6-61·2%) higher than expected for females aged 13-16, and 32·0% (95% CI 13·3-53·7%) higher for those aged 17-19. Similarly, the increase in self-harm incidence was driven by females aged 13-16, with the number of episodes being 38·3% (95% CI 20·7-58·5%) greater than expected. In contrast, incidence for both outcomes in males remained below or close to expected levels. The increases in incidence for both outcomes were attributable to larger rises in less deprived communities.
Interpretation
Although causes are uncertain, higher frequencies of eating disorder diagnoses and self-harm episodes among teenage females during the first two years of the pandemic highlights an urgent need for intervention. Early identification of mental health difficulties by primary care clinicians is necessary. Timely access to treatments and sufficient support from GPs and mental health services needs to be available to manage presenting problems and to prevent exacerbations of conditions.
Self-harm and eating disorders share multiple risk factors, with onset typically occurring during adolescence or early adulthood. We examined incidence rates among young people in the UK in the two years following the onset of the COVID-19 pandemic.
Methods
We conducted a population-based investigation of the primary care electronic health records of patients aged 10-24 years in the UK Clinical Practice Research Datalink (CPRD). Monthly incidence rates of eating disorders and self-harm, January 2010 through March 2022, were calculated. Based on antecedent trends, negative binomial regression models were fitted to predict rates after the pandemic began in March 2020. Percentage differences between observed and predicted rates were calculated to indicate changes following the onset of the pandemic.
Findings
Substantial increases in incidence of both outcomes were observed among young females since the onset of the pandemic. Incidence of eating disorder during the pandemic was 42·3% (95% CI 25·6-61·2%) higher than expected for females aged 13-16, and 32·0% (95% CI 13·3-53·7%) higher for those aged 17-19. Similarly, the increase in self-harm incidence was driven by females aged 13-16, with the number of episodes being 38·3% (95% CI 20·7-58·5%) greater than expected. In contrast, incidence for both outcomes in males remained below or close to expected levels. The increases in incidence for both outcomes were attributable to larger rises in less deprived communities.
Interpretation
Although causes are uncertain, higher frequencies of eating disorder diagnoses and self-harm episodes among teenage females during the first two years of the pandemic highlights an urgent need for intervention. Early identification of mental health difficulties by primary care clinicians is necessary. Timely access to treatments and sufficient support from GPs and mental health services needs to be available to manage presenting problems and to prevent exacerbations of conditions.
| Original language | English |
|---|---|
| Journal | The Lancet Child & Adolescent Health |
| Volume | 7 |
| Issue number | 7 |
| Early online date | 20 Jun 2023 |
| DOIs | |
| Publication status | E-pub ahead of print - 20 Jun 2023 |
