From the Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA.
the Department of Pediatrics, Harvard Medical School, Boston, MA.
J Pediatr Gastroenterol Nutr. 2023 Jun 1;76(6):743-748. doi: 10.1097/MPG.0000000000003774. Epub 2023 Mar 13.
There are no standard assessment approaches for Avoidant Restrictive Food Intake Disorder (ARFID). We describe our approach to multidisciplinary assessment after assessing more than 550 patients with ARFID. We collected online survey (ARFID-specific instruments, measures of anxiety, depression) measures. Electronic medical record data (mental health and gastrointestinal diagnoses, micronutrient and bone density assessments, and growth parameters) were extracted for the 239 patients with ARFID seen between 2018 and 2021 with both parent and patient responses to online surveys. We identified 5 subtypes/combinations of subtypes: low appetite; sensory sensitivity; fear + sensory sensitivity; fear + low appetite; fear + sensory sensitivity + low appetite. Those with appetite-only subtype had higher mean age (14.0 years, P < 0.01) and the lowest average body mass index z score (-1.74, P < 0.01) compared to other subtypes. Our experience adds to understanding of clinical presentations in patients with ARFID and may aid in assessment formulation.
目前尚无评估回避限制型食物摄入障碍（ARFID）的标准方法。我们在对 550 多名 ARFID 患者进行评估后，介绍了我们的多学科评估方法。我们收集了在线调查（ARFID 专用工具、焦虑和抑郁测量指标）数据，并提取了电子病历数据（心理健康和胃肠道诊断、微量营养素和骨密度评估以及生长参数）。这些数据来自 2018 年至 2021 年间就诊的 239 名 ARFID 患者，他们的父母和患者均对在线调查做出了回应。我们确定了 5 种亚型/亚型组合：低食欲；感官敏感；恐惧+感官敏感；恐惧+低食欲；恐惧+感官敏感+低食欲。仅表现出食欲障碍的患者的平均年龄（14.0 岁，P<0.01）和平均体重指数 z 评分最低（-1.74，P<0.01），与其他亚型相比。我们的经验增加了对 ARFID 患者临床表现的理解，可能有助于评估方案的制定。
