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Eating disorder symptoms and self-harm linked to higher levels of depression and anxiety during COVID-19 pandemic

7 December 2021

Young adults who have previously experienced self-harm or eating disorders reported higher levels of depression and anxiety during the pandemic, even when restrictions had eased, according to new research.

The study, led by the University of Bristol and funded by Elizabeth Blackwell Institute, Medical Research Council and Medical Research Foundation, has been published in the Journal of Eating Disorders. It looked at questionnaire information for 2,657 individuals from world-renowned health study Children of the 90s (also known as the Avon Longitudinal Study of Parents and Children) before and during the COVID-19 pandemic. 

Researchers analysed the relationship between previous reports of eating disorder symptoms and self-harm before the pandemic, and mental health problems (symptoms of depression and anxiety) and mental wellbeing during the COVID-19 pandemic. The study also assessed whether lifestyle changes, such as more sleep, relaxation techniques, or visiting green space, could be linked to mental health and wellbeing in young adults with and without previous eating disorder symptoms or self-harm. 

Researchers studied questionnaire data from 2017, when the participants were then aged 25 years, as well as data taken during the pandemic in 2020.  

At age 25, 32% of the 2,657 young adults reported at least one eating disorder symptom, 9% reported self-harm, and 5.5% reported both an eating disorder symptom and self-harm in the last year. 

During the pandemic, those with previously reported eating disorder symptoms and/or self-harm had more symptoms of depression and anxiety, and worse mental wellbeing, compared to individuals without previous symptoms. This remained the case after adjusting for their pre-pandemic levels of depression, anxiety and mental wellbeing.  

Lifestyle changes appeared to have little effect on the increased risk for mental health problems in those with prior eating disorder symptoms or self-harm. 

Lead author Dr Naomi Warne, Senior Research Associate at the University’s Centre for Academic Mental Health, said: “Eating disorders and self-harm are common and troubling mental health problems among young adults. In the UK, approximately 1.25 million people are living with an eating disorder and almost 1 in 15 adults report self-harm.  

“Our research has highlighted individuals with prior self-harm and eating disorder symptoms are key risk groups and further longitudinal research is needed to understand their ongoing mental health as well as risk and protective factors. 

“Individuals with previous eating disorder symptoms and self-harm should be considered vulnerable to depression and anxiety throughout the pandemic and beyond. Funding for rapid and responsive service provision is essential to reduce the impact of the pandemic on those with mental health problems.” 

Paper

'Disordered eating and self-harm as risk factors for poorer mental health during the COVID-19 pandemic: a UK-based birth cohort study' by Naomi Warne et al in Journal of Eating Disorders [open access]

Further information

Read the PolicyBristol research briefing

This work was supported by the Elizabeth Blackwell Institute, University of Bristol, with funding from QR SPF (Quality-Related Strategic Priorities Fund), UKRI Research England, and funding from the Wellcome Trust ISSF3 grant 204813/Z/16/Z. This work was also supported by funding from the Medical Research Council/Medical Research Foundation (MRC/MRF grant number MR/S020292/1).  

About Children of the 90s 
Based at the University of Bristol, Children of the 90s, also known as the Avon Longitudinal Study of Parents and Children (ALSPAC), is a long-term health-research project that enrolled more than 14,500 pregnant women in 1991 and 1992. It has been following the health and development of the parents and their children in detail ever since and is currently recruiting the children of the original children into the study. 

The study has a huge catalogue of data and biosamples and continues to be used to collect new material. These resources can be used to quickly answer policy questions that arise given current conditions. Rapid response to important social and health questions has been a hallmark of the Children of the 90s’ contribution to COVID-19. Contributions have varied widely - from asking about the age of grandparents or the social and health effects of lockdown to finding out how long immunity lasts or how effective vaccines will be. 

The study receives core funding from the Medical Research Council, the Wellcome Trust and the University of Bristol, where it is based. Find out more at www.childrenofthe90s.ac.uk

About Elizabeth Blackwell Institute 
Nurturing research. Improving health. 

The Elizabeth Blackwell Institute drives innovation in research to improve health for all. It nurtures interdisciplinary research to address the complex health challenges facing us today. 

The institute focuses on: 

  • Supporting the next generation of health researchers 
  • Connecting people to develop interdisciplinary research 
  • Including everyone in research so the research can benefit all. 
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