{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:12:53Z","timestamp":1788347573273,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01 MH110445"],"award-info":[{"award-number":["R01 MH110445"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K24 MH113737"],"award-info":[{"award-number":["K24 MH113737"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005197","name":"Hilda and Preston Davis Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005197","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The COVID\u201019 pandemic was associated with a worldwide increase in hospitalizations among adolescents with anorexia nervosa (AN). The factors contributing to this remain unclear and may include alterations in healthcare systems and\/or clinical factors. This study examined the possibility that pandemic\u2010related stress led to more severe illness in adolescents with AN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants included adolescents with AN and healthy controls (HC) enrolled in a longitudinal study between 2017 and 2022. Illness severity and response to treatment were compared between individuals enrolled pre\u2010COVID\u201019 and mid\u2010COVID\u201019, with HC providing an additional reference for community levels of mood, anxiety, and eating symptoms. Exposure to COVID\u201019\u2010related stress was assessed systematically, and the effect on illness severity was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were no significant differences in age, body mass index (BMI), or eating disorder\/depression\/anxiety severity between individuals who presented for evaluation of AN pre\u2010COVID\u201019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960) versus mid\u2010COVID\u201019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200931). Illness duration was shorter in the mid\u2010COVID\u201019 group (\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>mid\u2010COVID<\/jats:sub>\n                      \u2009=\u20090.30\u2009\u00b1\u20090.35 vs.\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>pre\u2010COVID<\/jats:sub>\n                      \u2009=\u20090.83\u2009\u00b1\u20091.07\u2009years,\n                      <jats:italic>t<\/jats:italic>\n                      <jats:sub>88<\/jats:sub>\n                      \u2009=\u20092.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Duration of restrictive eating was also shorter in the mid\u2010COVID\u201019 group (\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>mid\u2010COVID<\/jats:sub>\n                      \u2009=\u20091.4\u2009\u00b1\u20091.1\u2009years vs.\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>pre\u2010COVID<\/jats:sub>\n                      \u2009=\u20092.4\u2009\u00b1\u20092.1\u2009years,\n                      <jats:italic>t<\/jats:italic>\n                      <jats:sub>88<\/jats:sub>\n                      =\u20092.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Individuals with AN and HC showed similar levels of COVID\u2010related stress, and there was little association between COVID\u201019\u2010related stress and symptom severity or response to treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study suggests that while the pandemic led to increased incidence and hospitalizations for AN, there may have been less impact on overall illness severity and treatment response. For some, pandemic\u2010related circumstances might have influenced hospitalization rates more than the level of pandemic\u2010related stress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/eat.70134","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T03:50:48Z","timestamp":1779767448000},"page":"2025-2034","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>COVID<\/scp>\n                    \u201019\u2010Related Stress and Adolescent Anorexia Nervosa: Early Detection, Similar Illness Course"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9753-7909","authenticated-orcid":false,"given":"Daniel H.","family":"Vaccaro","sequence":"first","affiliation":[{"name":"Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6578-8568","authenticated-orcid":false,"given":"Zhijun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center  New York New York USA"},{"name":"Institute for Health Rutgers University  New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanjia","family":"Wang","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center  New York New York USA"},{"name":"Mailman School of Public Health Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9663-3790","authenticated-orcid":false,"given":"Xinwei","family":"Han","sequence":"additional","affiliation":[{"name":"Mailman School of Public Health Columbia University  New York New York USA"},{"name":"New York State Psychiatric Institute  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8626-5859","authenticated-orcid":false,"given":"B. 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