Department of Psychology, University of Wyoming, Laramie, Wyoming, USA.
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
Int J Eat Disord. 2022 Oct;55(10):1397-1403. doi: 10.1002/eat.23777. Epub 2022 Jul 18.
Research comparing psychiatric comorbidities between individuals with avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) is limited. ARFID often develops in childhood, whereas AN typically develops in adolescence or young adulthood. Understanding how age may impact differential psychological comorbidity profiles is important to inform etiological conceptualization, differential diagnosis, and treatment planning. We aimed to compare the lifetime frequency of psychiatric comorbidities and suicidality between females with ARFID (n = 51) and AN (n = 40), investigating the role of age as a covariate.
We used structured interviews to assess the comparative frequency of psychiatric comorbidities/suicidality.
When age was omitted from analyses, females with ARFID had a lower frequency of depressive disorders and suicidality compared to AN. Adjusting for age, only suicidality differed between groups.
This is the first study to compare comorbidities in a similar number of individuals with ARFID and AN, and a structured clinical interview to confer ARFID and comorbidities, covarying for age, and the first to compare suicidality. Although suicidality is at least three times less common in ARFID than AN, observed differences in other psychiatric comorbidities may reflect ARFID's relatively younger age of presentation compared to AN.
Our results highlight that, with the exception of suicidality, which was three times less common in ARFID than AN irrespective of age, observed differences in psychiatric comorbidities in clinical practice may reflect ARFID's younger age at clinical presentation compared to AN.
比较回避/限制型进食障碍（ARFID）和神经性厌食症（AN）患者的精神共病情况的研究有限。ARFID 通常在儿童期发展，而 AN 通常在青少年或成年早期发展。了解年龄如何影响不同的心理共病特征对于告知病因概念化、鉴别诊断和治疗计划非常重要。我们旨在比较有 ARFID（n=51）和 AN（n=40）的女性患者一生中的精神共病和自杀率，研究年龄作为协变量的作用。
我们使用结构化访谈来评估精神共病/自杀的比较频率。
当分析中不包括年龄时，与 AN 相比，ARFID 女性的抑郁障碍和自杀率较低。调整年龄后，只有自杀率在两组之间存在差异。
这是第一项比较 ARFID 和 AN 患者数量相似的共病情况的研究，也是第一项使用结构化临床访谈来确诊 ARFID 和共病情况、协方差年龄以及比较自杀率的研究。尽管 ARFID 的自杀率至少比 AN 低三倍，但观察到的其他精神共病差异可能反映了 ARFID 与 AN 相比，发病年龄相对较年轻。
我们的研究结果表明，除了自杀率外，ARFID 的自杀率无论年龄大小都比 AN 低三倍，而在临床实践中观察到的精神共病差异可能反映了 ARFID 与 AN 相比，发病年龄相对较年轻。
