Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.
Cleveland Clinic Office of Civic Education Initiatives, Beachwood, Ohio.
J Adolesc Health. 2015 Dec;57(6):673-8. doi: 10.1016/j.jadohealth.2015.08.003. Epub 2015 Oct 1.
Avoidant/restrictive food intake disorder (ARFID), a recently defined Diagnostic and Statistical Manual of Mental Disorders-5 eating disorder diagnosis, has not been extensively studied in the inpatient population. This study compares hospitalized ARFID and anorexia nervosa (AN) patients, including differences in presentation, treatment response, and 1-year outcomes.
We conducted a retrospective chart review of ARFID and AN patients hospitalized between 2008 and 2014 for acute medical stabilization at an academic medical center. Data, including characteristics on admission, during hospitalization, and 1 year after discharge, were recorded for each patient and compared between ARFID and AN patients.
On presentation, ARFID patients (n = 41) were younger with fewer traditional eating disorder behaviors and less weight loss, comorbidity, and bradycardia than AN patients (n = 203). During hospitalization, although ARFID and AN patients had similar caloric intake, ARFID patients relied on more enteral nutrition and required longer hospitalizations than AN patients (8 vs. 5 days; p = .0006). One year after discharge, around half of ARFID and AN patients met criteria for remission (62% vs. 46%; p = .18), and less than one-quarter required readmission (21% vs. 24%; p = .65).
The findings from this study reveal several differences in hospitalized eating disorder patients and emphasize the need for further research on ARFID patients, including research on markers of illness severity and optimal approaches to refeeding. Similar remission and readmission rates among ARFID and AN patients highlight both the success and the continued need for improvement in eating disorder treatment regardless of diagnosis.
回避/限制型食物摄入障碍（ARFID）是最近在《精神障碍诊断与统计手册》第 5 版中定义的一种饮食障碍诊断，尚未在住院人群中进行广泛研究。本研究比较了住院 ARFID 和神经性厌食症（AN）患者，包括表现、治疗反应和 1 年结局的差异。
我们对 2008 年至 2014 年期间在学术医疗中心因急性医疗稳定而住院的 ARFID 和 AN 患者进行了回顾性病历审查。记录每位患者入院时、住院期间和出院后 1 年的数据，并对 ARFID 和 AN 患者进行比较。
在入院时，ARFID 患者（n=41）年龄较小，传统的饮食障碍行为较少，体重减轻、合并症和心动过缓较少，而 AN 患者（n=203）则更多。在住院期间，尽管 ARFID 和 AN 患者的热量摄入相似，但 ARFID 患者更依赖肠内营养，住院时间也比 AN 患者长（8 天 vs. 5 天；p=0.0006）。出院后 1 年，大约一半的 ARFID 和 AN 患者符合缓解标准（62% vs. 46%；p=0.18），不到四分之一的患者需要再次入院（21% vs. 24%；p=0.65）。
本研究的结果揭示了住院饮食障碍患者的几个差异，并强调需要对 ARFID 患者进行进一步研究，包括对疾病严重程度标志物和最佳喂养方法的研究。ARFID 和 AN 患者的缓解和再入院率相似，突出了无论诊断如何，饮食障碍治疗的成功和持续改进的必要性。
