Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
Int J Eat Disord. 2020 Oct;53(10):1636-1646. doi: 10.1002/eat.23355. Epub 2020 Aug 9.
Little is known about the optimal treatment of avoidant/restrictive food intake disorder (ARFID). The purpose of this study was to evaluate feasibility, acceptability, and proof-of-concept for cognitive-behavioral therapy for ARFID (CBT-AR) in children and adolescents.
Males and females (ages 10-17 years) were offered 20-30 sessions of CBT-AR delivered in a family-based or individual format.
Of 25 eligible individuals, 20 initiated treatment, including 17 completers and 3 dropouts. Using intent-to-treat analyses, clinicians rated 17 patients (85%) as "much improved" or "very much improved." ARFID severity scores (on the Pica, ARFID, and Rumination Disorder Interview) significantly decreased per both patient and parent report. Patients incorporated a mean of 16.7 (SD = 12.1) new foods from pre- to post-treatment. The underweight subgroup showed a significant weight gain of 11.5 (SD = 6.0) pounds, moving from the 10th to the 20th percentile for body mass index. At post-treatment, 70% of patients no longer met criteria for ARFID.
This is the first study of an outpatient manualized psychosocial treatment for ARFID in older adolescents. Findings provide evidence of feasibility, acceptability, and proof-of-concept for CBT-AR. Randomized controlled trials are needed.
对于回避/限制型食物摄入障碍（ARFID）的最佳治疗方法知之甚少。本研究旨在评估认知行为疗法（CBT-AR）对儿童和青少年 ARFID 的可行性、可接受性和概念验证。
招募年龄在 10-17 岁的男性和女性，提供 20-30 次基于家庭或个体的 CBT-AR 治疗。
在 25 名符合条件的个体中，有 20 名开始接受治疗，包括 17 名完成者和 3 名脱落者。使用意向治疗分析，临床医生评估 17 名患者（85%）为“明显改善”或“非常明显改善”。ARFID 严重程度评分（在摄食障碍问卷、ARFID 和反刍障碍访谈中）在患者和家长报告中均显著降低。患者在治疗前后平均摄入了 16.7（SD=12.1）种新食物。体重不足亚组的体重显著增加了 11.5（SD=6.0）磅，从 BMI 的第 10 百分位上升到第 20 百分位。治疗后，70%的患者不再符合 ARFID 的标准。
这是第一项针对青少年晚期门诊心理社会治疗 ARFID 的研究。研究结果为 CBT-AR 的可行性、可接受性和概念验证提供了证据。需要进行随机对照试验。
