Hospitalizations for Anorexia Nervosa during the COVID-19 Pandemic in France: A Nationwide Population-Based Study

The COVID-19 pandemic has had a detrimental impact on mental health, including on food-related behaviors. However, little is known about the effect of the pandemic on anorexia nervosa (AN). We sought to assess an association between the COVID-19 pandemic and a potential increase in hospitalizations for AN in France. We compared the number of hospitalizations with a diagnosis of AN during the 21-month period following the onset of the pandemic with the 21-month period before the pandemic using Poisson regression models. We identified a significant increase in hospitalizations for girls aged 10 to 19 years (+45.9%, RR = 1.46[1.43–1.49]; p < 0.0001), and for young women aged 20 to 29 (+7.0%; RR = 1.07[1.04–1.11]; p < 0.0001). Regarding markers of severity, there was an increase in hospitalizations for AN associated with a self-harm diagnosis between the two periods. Multivariate analysis revealed that the risk of being admitted for self-harm with AN increased significantly during the pandemic period among patients aged 20–29 years (aOR = 1.39[1.06–1.81]; p < 0.05 vs. aOR = 1.15[0.87–1.53]; NS), whereas it remained high in patients aged 10 to 19 years (aOR = 2.40[1.89–3.05]; p < 0.0001 vs. aOR = 3.12[2.48–3.98]; p < 0.0001). Furthermore, our results suggest that the pandemic may have had a particular effect on the mental health of young women with AN, with both a sharp increase in hospitalizations and a high risk of self-harming behaviors.