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回避/限制型食物摄入障碍:一种在喂养和进食障碍交汇处的诊断,需要进行亚型分化。

Avoidant/restrictive food intake disorder: A diagnosis at the intersection of feeding and eating disorders necessitating subtype differentiation.

机构信息

Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.

Children's Multidisciplinary Feeding Program, Children's Healthcare of Atlanta, Atlanta, Georgia.

出版信息

Int J Eat Disord. 2019 Apr;52(4):398-401. doi: 10.1002/eat.22987. Epub 2019 Jan 11.

Abstract

Avoidant/restrictive food intake disorder (ARFID) is a diagnosis that sits squarely at the cross roads of feeding disorders and eating disorders. It is historically tied to feeding disorders as a replacement of the DSM-IV diagnosis of feeding disorder of infancy or early childhood. The revision process, however, extended the diagnostic umbrella by removing its predecessor's weight loss requirement and age of onset restriction (i.e., 6 years). Implications of this extension include capturing an older cohort of patients with ARFID accessing care at eating disorders clinics, as well as providing a diagnostic home to previously orphaned pediatric subgroups with feeding disorders that lacked a diagnostic home prior to DSM-5. While recognizing notable strengths of this now 5-year-old diagnostic entity, ARFID is largely recognized as a very heterogeneous condition that lacks specificity to best guide clinical and research activities. The current commentary discusses the implications of ARFID as a replacement and extension of the DSM-IV diagnosis of feeding disorder of infancy or early childhood and provides the rationale and guidance for developing a subtype taxonomy.

摘要

回避/限制型食物摄入障碍(ARFID)是一种位于喂养障碍和进食障碍交叉点的诊断。它在历史上与喂养障碍有关,是DSM-IV 婴儿或幼儿期喂养障碍诊断的替代诊断。然而,修订过程通过删除其前身的体重减轻要求和发病年龄限制(即 6 岁),扩展了诊断范围。这一扩展的影响包括将更多的 ARFID 患者纳入饮食障碍诊所的治疗中,以及为之前缺乏 DSM-5 之前诊断标准的患有喂养障碍的儿科亚群提供一个诊断归宿。尽管认识到这个已有 5 年历史的诊断实体的显著优势,但 ARFID 很大程度上被认为是一种非常异质的疾病,缺乏特异性,无法很好地指导临床和研究活动。本评论讨论了 ARFID 作为 DSM-IV 婴儿或幼儿期喂养障碍诊断的替代和扩展的意义,并为发展亚类分类提供了理由和指导。

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