Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Int J Eat Disord. 2019 Apr;52(4):410-418. doi: 10.1002/eat.23037. Epub 2019 Feb 7.
The aim of this study was to compare health related quality of life (HRQOL) in infants and children with avoidant restrictive food intake disorder (ARFID) to healthy and chronically ill controls.
A cross-sectional study was conducted in children who meet ARFID criteria at our tertiary care pediatric feeding clinic (September 2014 to July 2016). Before consultation, parents of patients (n = 100) were asked to complete questionnaires to determine HRQOL: the TNO-AZL Preschool Children Quality of Life (0-5 years), and "Pediatric Quality of Life Inventory" (6-7 and 8-10 years). HRQOL of ARFID patients was compared to both healthy (0-5 years n = 241; 6-7 years n = 61; 8-10 years n = 192) and chronically ill (0-5 years n = 79; 6-7 years n = 11; 8-10 years n = 26) controls.
The prevalence of ARFID was 64%. HRQOL of ARFID patients aged 0-5 years (n = 37) was significantly lower on 6/12 scales (appetite, lungs, stomach, motor functioning, positive mood and liveliness) compared to healthy controls (P < .01), and on 4/12 scales (appetite, stomach, motor functioning, and liveliness) compared to chronically ill controls (P < .01). The ARFID patients scored significantly better on the problem behavior scale compared to healthy and chronically ill controls (P < .01). ARFID patients aged 6-7 (n = 9) had significantly lower scores in 3/6 scales (total score, psychosocial health, and school functioning) (P < .01), and aged 8-10 (n = 2) had a significantly lower school functioning scale (P < .01) compared to healthy controls.
HRQOL of children with ARFID is decreased on multiple scales. The effect on HRQOL should be incorporated in clinical practice, and clinical studies should add HRQOL as an outcome measure.
本研究旨在比较回避限制型进食障碍(ARFID)患儿与健康儿童和慢性病患儿的健康相关生活质量(HRQOL)。
在我们的三级儿科喂养诊所(2014 年 9 月至 2016 年 7 月)中,对符合 ARFID 标准的患儿进行了横断面研究。在就诊前,患儿家长(n=100)填写了调查问卷以确定 HRQOL:TNO-AZL 学龄前儿童生活质量量表(0-5 岁)和“儿童生活质量量表”(6-7 岁和 8-10 岁)。将 ARFID 患儿的 HRQOL 与健康对照组(0-5 岁 n=241;6-7 岁 n=61;8-10 岁 n=192)和慢性病对照组(0-5 岁 n=79;6-7 岁 n=11;8-10 岁 n=26)进行比较。
ARFID 的患病率为 64%。0-5 岁 ARFID 患儿(n=37)的 HRQOL 在 6/12 个量表(食欲、肺部、胃部、运动功能、积极情绪和活力)上明显低于健康对照组(P<.01),在 4/12 个量表(食欲、胃部、运动功能和活力)上明显低于慢性病对照组(P<.01)。与健康对照组和慢性病对照组相比,ARFID 患儿在问题行为量表上的得分明显更高(P<.01)。6-7 岁 ARFID 患儿(n=9)在 3/6 个量表(总分、心理社会健康和学校功能)上的得分明显较低(P<.01),8-10 岁 ARFID 患儿(n=2)在学校功能量表上的得分明显较低(P<.01)。
ARFID 患儿的 HRQOL 在多个量表上均有所下降。在临床实践中应考虑 HRQOL 的影响,并应将其作为临床研究的结果指标。