Schöffel Hannah, Hiemisch Andreas, Kiess Wieland, Hilbert Anja, Schmidt Ricarda
Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, University of Leipzig Medical Center, Leipzig, Germany.
LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.
Eur Eat Disord Rev. 2021 Jan;29(1):60-73. doi: 10.1002/erv.2799. Epub 2020 Oct 22.
Although patients with avoidant/restrictive food intake disorder (ARFID) often consult general paediatric services initially, existing literature mostly concentrated on intensive eating disorder treatment settings. This cross-sectional study sought to describe symptoms of ARFID and their associations with eating disorder psychopathology, quality of life, anthropometry, and physical comorbidities in a general paediatric sample.
In N = 111 patients (8-18 years) seeking treatment for physical diseases, prevalence of ARFID-related restrictive eating behaviours was estimated by self-report and compared to population-based data (N = 799). Using self-report and medical record data, further ARFID diagnostic criteria were evaluated. Patients with versus without symptoms of ARFID based on self-report and medical records were compared in diverse clinical variables.
The prevalence of self-reported symptoms of ARFID was not higher in the inpatient than population-based sample. Only picky eating and shape concern were more common in the inpatient than population-based sample. Although 68% of the inpatient sample reported any restrictive eating behaviours, only 7% of patients showed symptoms of ARFID based on medical records in addition to self-report, particularly those with underweight, without significant effects for age, sex, and medical diagnoses.
The study revealed the importance of considering ARFID within the treatment of children and adolescents with physical diseases, especially for those with underweight. Further research is needed to replicate the findings with interview-based measures and to investigate the direction of effects in ARFID and its physical correlates.
尽管回避/限制性食物摄入障碍（ARFID）患者最初常寻求普通儿科服务，但现有文献大多集中在饮食失调的强化治疗环境。这项横断面研究旨在描述普通儿科样本中ARFID的症状及其与饮食失调心理病理学、生活质量、人体测量学和身体合并症的关联。
在111名（8至18岁）因身体疾病寻求治疗的患者中，通过自我报告估计ARFID相关限制性饮食行为的患病率，并与基于人群的数据（799人）进行比较。使用自我报告和病历数据，评估进一步的ARFID诊断标准。根据自我报告和病历，比较有无ARFID症状的患者在不同临床变量中的情况。
住院患者中自我报告的ARFID症状患病率并不高于基于人群的样本。只有挑食和对体型的关注在住院患者中比基于人群的样本更常见。尽管68%的住院患者样本报告了任何限制性饮食行为，但根据病历，除自我报告外，只有7%的患者表现出ARFID症状，尤其是体重过轻的患者，且对年龄、性别和医学诊断无显著影响。
该研究揭示了在治疗患有身体疾病的儿童和青少年时考虑ARFID的重要性，特别是对于体重过轻的患者。需要进一步研究以通过基于访谈的测量方法重复这些发现，并调查ARFID及其身体相关因素的影响方向。
