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Analysis of institutional authors

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Increase in admission rates and symptom severity of childhood and adolescent anorexia nervosa in Europe during the COVID-19 pandemic: data from specialized eating disorder units in different European countries

Publicated to:Child And Adolescent Psychiatry And Mental Health. 16 (1): 46- - 2022-06-20 16(1), DOI: 10.1186/s13034-022-00482-x

Authors: Gilsbach, S; Herpertz-Dahlmann, B; Plana, MT; Castro-Fornieles, J; Flamarique, I; Gatta, M; Karlsson, GP; Solberg, AL; Raynaud, JP; Riva, A; Nacinovich, R; van Elburg, AA; Wentz, E

Affiliations

Rhein Westfal TH Aachen, Dept Child & Adolescent Psychiat Psychosomat & Ps, Neuenhofer Weg 21, D-52064 Aachen, Germany - Author
Rintveld, Altrecht Mental Hlth Inst, Ctr Eating Disorders, NL-3705 WE Zeist, Netherlands - Author
Univ Barcelona, Hosp Clin Barcelona, Inst Clin Neurosci, IDIBAPS,CIBERSAM,Child & Adolescent Psychiat & Ps, C Villarroel 170,I2017SGR88108036, Barcelona, Spain - Author
Univ Gothenburg, Sahlgrenska Univ Hosp, Eating Disorder Ctr Children & Young Adults, Vitaminvagen 17, S-41650 Gothenburg, Sweden - Author
Univ Gothenburg, Sahlgrenska Univ Hosp, Sahlgrenska Acad,Atstorningsmottagning Hogsbo, Inst Neurosci & Physiol,Dept Psychiat & Neurochem, Lilla Kapplandsgatan 26B, S-42137 Vastra Frolunda, Sweden - Author
Univ Milano Bicocca, San Gerardo Hosp, Child & Adolescent Mental Hlth, Via GB Pergolesi 33, I-20900 Monza, MB, Italy - Author
Univ Padua, Univ Hosp Padova, Woman & Child Hlth Dept, Children & Adolescents Neuropsychiat Unit, Via 8 Febbraio 2, I-35122 Padua, PD, Italy - Author
Univ Toulouse, Serv Univ Psychiat Enfant & Adolescent, Hop Purpan, CHU Toulouse, Pl Docteur Baylac, F-31059 Toulouse 9, France - Author
Univ Utrecht, Fac Social Sci, Heidelberglaan 1, NL-3584 CS Utrecht, Netherlands - Author
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Abstract

The COVID-19 pandemic, associated with confinement and social isolation, seems to have impacted the course of many mental disorders in children and adolescents. An increase in hospital admission rates for juvenile anorexia nervosa (AN) has been documented in many regions of the world. However, data from Europe are scarce.We asked clinicians in specialized eating disorder units in hospitals of maximum care in France, Germany, Italy, Spain, Sweden, and the Netherlands to report on (i) overall (inpatient and outpatient) and (ii) inpatient admission rates for adolescents with AN during 2019 and 2020. Additionally, a modified version of the COVID Isolation Eating Scale (CIES) was used to assess the child and adolescent psychiatrists' estimations of a possible increase in symptom severity in children and adolescents with AN during the COVID-19 pandemic and to (iii) inquire about the contributing factors perceived by the caring professionals.Four out of six representatives of European hospitals described a higher rate of overall admissions during the pandemic. Three hospitals out of six reported an increase in inpatient admissions, and two centres had constant high numbers of admissions of both outpatients and inpatients. The clinicians perceived a higher symptom severity in 2020 than in 2019, especially involving more frequent use of social media, longer duration of exercising, and more restrictive eating. They supposed an increase in social media consumption, a perceived "loss of control", and a lack of in-person assessments and weight controls as the main contributing factors for the deterioration in AN numbers and symptomatology.The COVID-19 pandemic seems to have had a deep impact on symptom severity in AN, which is mirrored by a large increase in admission rates across Europe. An increase in exercise, social media consumption, a perceived "loss of control", and a lack of face-to-face health care seem to have contributed to this development. Further investigation is required to identify which factors may lead to the increase in incidence and deterioration of childhood and adolescent AN. Possible preventive means for the future could include educating paediatricians and health care workers about AN, regular weight assessment, and home-based treatments.© 2022. The Author(s).

Keywords

anorexia nervosaeuropehospital admissionsAdolescentAnorexia nerviosaAnorexia nervosaArticleChildClinicianCoronavirus disease 2019Covid-19Covid-19 pandemicDisease severityEuropaEuropeFranceGermanyHospital admissionHospital admission and dischargeHospital admissionsHospital patientHumanIngressos i altes en els hospitalsItalyMedical expertNetherlandsOutpatientPandemicPatient careSocial mediaSpainStandardizationSweden

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Child And Adolescent Psychiatry And Mental Health due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 10/130, thus managing to position itself as a Q1 (Primer Cuartil), in the category Pediatrics. Notably, the journal is positioned above the 90th percentile.

This publication has been distinguished as a “Highly Cited Paper” by the agencies WoS (ESI, Clarivate) and ESI (Clarivate), meaning that it ranks within the top 1% of the most cited articles in its thematic field during the year of its publication. In terms of the observed impact of the contribution, this work is considered one of the most influential worldwide, as it is recognized as highly cited. (source consulted: ESI Nov 14, 2024)

And this is evidenced by the extremely high normalized impacts through some of the main indicators of this type, which, although dynamic over time and dependent on the set of average global citations at the time of calculation, already indicate that they are well above the average in different agencies:

  • Normalization of citations relative to the expected citation rate (ESI) by the Clarivate agency: 9.13 (source consulted: ESI Nov 14, 2024)
  • Weighted Average of Normalized Impact by the Scopus agency: 10.94 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 25.84 (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-23, the following number of citations:

  • WoS: 43
  • Scopus: 58
  • Europe PMC: 13
  • OpenCitations: 41

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-23:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 203.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 203 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 5.2.
  • The number of mentions on the social network X (formerly Twitter): 8 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
  • Assignment of a Handle/URN as an identifier within the deposit in the Institutional Repository: http://hdl.handle.net/2445/199900

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: France; Germany; Italy; Netherlands; Oman; Sweden.