Sader Michelle, Weston Annabel, Buchan Kyle, Kerr-Gaffney Jess, Gillespie-Smith Karri, Sharpe Helen, Duffy Fiona
School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
The Eating Disorders and Autism Collaborative (EDAC), University of Edinburgh, Edinburgh, UK.
Int J Eat Disord. 2025 Mar;58(3):473-488. doi: 10.1002/eat.24369. Epub 2025 Jan 6.
Avoidant/restrictive food intake disorder (ARFID) is a feeding and eating disorder characterized by extensive avoidance and/or restriction of food. Existing research demonstrates that ARFID is over-represented in Autistic populations and vice-versa, with both groups exhibiting shared characteristics. This meta-analysis investigated the co-occurrence between ARFID and autism via determination of autism prevalence in ARFID populations, and ARFID prevalence in Autistic groups.
This review systematically identified literature evaluating those with ARFID and Autistic individuals. Literature was searched for using SCOPUS, MEDLINE, and Web of Science. Selected publications included Autistic individuals and those with ARFID who either received a formal diagnosis of autism and/or ARFID or met clinical threshold cut-off scores on validated autism and/or ARFID questionnaires. Prevalence was reported in proportion-based values alongside 95% confidence intervals (CIs).
This meta-analysis identified 21 studies (kARFID = 18 papers; kAutism = 3 papers) comprising of n = 7442 participants (nARFID = 1708; nAutism = 5734). Prevalence of autism diagnoses was 16.27% in those with ARFID (95% CI = 8.64%-28.53%), and ARFID prevalence in Autistic groups was 11.41% (95% CI = 2.89%-35.76%). Gender and ethnicity served as significant sources of heterogeneity in ARFID papers. There was insufficient data to provide comparator values or prevalence across study population and distinct underpinning drivers of ARFID.
Meta-analytic findings highlight significant rates of co-occurrence between autism and ARFID, suggesting that in clinical settings, it may be beneficial to consider screening Autistic individuals for ARFID and vice-versa. Future research should further investigate co-occurrence across ARFID profiles, gender, and ethnicity.
回避/限制性食物摄入障碍（ARFID）是一种以广泛回避和/或限制食物为特征的进食障碍。现有研究表明，ARFID在自闭症人群中比例过高，反之亦然，两组具有共同特征。本荟萃分析通过确定ARFID人群中的自闭症患病率以及自闭症群体中的ARFID患病率，研究了ARFID与自闭症之间的共病情况。
本综述系统地检索了评估ARFID患者和自闭症个体的文献。使用SCOPUS、MEDLINE和科学网进行文献检索。入选的出版物包括自闭症个体和ARFID患者，他们要么接受了自闭症和/或ARFID的正式诊断，要么在经过验证的自闭症和/或ARFID问卷上达到临床阈值截断分数。患病率以基于比例的值以及95%置信区间（CI）报告。
本荟萃分析确定了21项研究（kARFID = 18篇论文；k自闭症 = 3篇论文），共7442名参与者（nARFID = 1708；n自闭症 = 5734）。ARFID患者中自闭症诊断的患病率为16.27%（95% CI = 8.64% - 28.53%），自闭症群体中ARFID的患病率为11.41%（95% CI = 2.89% - 35.76%）。性别和种族是ARFID论文中异质性的重要来源。没有足够的数据提供对照值或整个研究人群的患病率以及ARFID不同的潜在驱动因素。
荟萃分析结果突出了自闭症与ARFID之间的显著共病率，表明在临床环境中，考虑对自闭症个体进行ARFID筛查以及反之亦然可能是有益的。未来的研究应进一步调查ARFID特征、性别和种族之间的共病情况。
