Plain English summary The Coronavirus Disease 2019 (COVID-19) is a global pandemic and posed serious challenges in many countries. This study aimed to investigate the psychological distress level of the primary caregivers of eating disorder (ED) offspring during the COVID-19 pandemic, and to explore potential influencing factors. From March 6 to April 20, 2020, 378 questionnaires for primary caregivers of ED offspring and 1163 questionnaires for primary caregivers of healthy offspring were collected through an online crowdsourcing platform in mainland China. All primary caregivers were evaluated for depression, anxiety, perceived stress and social support. 315 primary caregivers of ED offspring and 315 matched primary caregivers of healthy offspring were included in the statistical analysis. We compared the primary caregivers of ED offspring with the primary caregivers of healthy offspring for depression, anxiety, perceived stress and social support. We found that primary caregivers of ED offspring experienced more psychological distress than that of primary caregivers of healthy offspring. ED caregivers with high perceived stress may have higher levels of depression and anxiety. ED caregivers with high social support, no mental illness and no family conflicts may have lower levels of depression. ED caregivers with high social support, no family conflicts, and high years of education may have lower levels of anxiety.
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