Eating Disorders Clinical and Research Program, Massachusetts General Hospital.
Department of Psychiatry, Harvard Medical School.
Curr Opin Psychiatry. 2018 Nov;31(6):425-430. doi: 10.1097/YCO.0000000000000454.
Avoidant/restrictive food intake disorder (ARFID) was added to the psychiatric nomenclature in 2013, but little is known about its optimal treatment. The purpose of this article is to review the recent literature on ARFID treatment and highlight a novel cognitive-behavioral approach, currently under study.
The current evidence base for ARFID treatment relies primarily on case reports, case series, and retrospective chart reviews, with only a handful of randomized controlled trials in young children. Studies in adults are lacking. ARFID treatments recently described in the literature include family-based treatment and parent training; cognitive-behavioral approaches; hospital-based re-feeding including tube feeding; and adjunctive pharmacotherapy. A novel form of outpatient cognitive-behavioral therapy for ARFID (CBT-AR) is one treatment currently under study. CBT-AR is appropriate for children, adolescents, and adults ages 10 years and more; proceeds through four stages across 20-30 sessions; and is available in both individual and family-supported versions.
There is no evidence-based psychological treatment suitable for all forms of ARFID at this time. Several groups are currently evaluating the efficacy of new psychological treatments for ARFID - particularly, family-based and cognitive-behavioral approaches - but results have not yet been published.
回避/限制型食物摄入障碍（ARFID）于 2013 年被纳入精神疾病命名法，但对其最佳治疗方法知之甚少。本文旨在综述 ARFID 治疗的最新文献，并重点介绍一种新颖的认知行为方法，目前正在研究中。
ARFID 治疗的现有证据基础主要依赖于病例报告、病例系列和回顾性图表审查，仅有少数针对幼儿的随机对照试验。成人研究则缺乏。文献中最近描述的 ARFID 治疗方法包括家庭为基础的治疗和家长培训；认知行为方法；包括管饲在内的医院重新喂养；以及辅助药物治疗。一种新颖的 ARFID 门诊认知行为疗法（CBT-AR）是目前正在研究的一种治疗方法。CBT-AR 适用于 10 岁及以上的儿童、青少年和成年人；分为四个阶段，共 20-30 次；可提供个体和家庭支持版本。
目前尚无适用于所有形式 ARFID 的基于证据的心理治疗方法。目前有几个团体正在评估新的 ARFID 心理治疗方法的疗效，特别是家庭为基础和认知行为方法，但结果尚未公布。
