Liu Meichen, Chang Yiheng, Xie Xueting, Liu Yudan, Tian Shiyun, Yang Chun, Zhao Ziqi, Zhang Huimin
Department of Neurology, the First Affiliated Hospital, Dalian Medical University, Dalian, China.
Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, China.
Front Psychiatry. 2025 Jan 15;15:1450800. doi: 10.3389/fpsyt.2024.1450800. eCollection 2024.
Avoidant/restrictive food intake disorder (ARFID), a DSM-5-introduced eating disorder, is increasingly prevalent and challenging to treat, primarily affecting children and adolescents, with limited adult case reports. This rarity in adults leads to misdiagnosis or underdiagnosis, and treatment experiences are scarce.
This report details an adult ARFID case, where the patient's fear of food intake followed gastric damage from corn ingestion, resulting in a restrictive diet of rice porridge due to gastric pain. The behavior is driven by fear of eating-related adverse effects.
Based on clinical symptoms assessment, semi-structured interviews, and comprehensive testing, including PET/MRI scans to exclude secondary conditions, a diagnosis of ARFID was confirmed. ARFID, a newly introduced diagnosis in the DSM-5, is uncommon in adults with sparse case data. Differentiating it from gastrointestinal diseases and other psychiatric conditions is crucial for precise diagnosis and focused treatment.
In this paper, we report on the clinical diagnosis, imaging manifestations, treatment, and follow-up of an adult ARFID case, highlighting the utility of neuroimaging in diagnosis and differentiation. It also assesses the therapeutic efficacy of olanzapine, escitalopram oxalate, and fluoxetine hydrobromide, offering clinical guidance for diagnosing and managing ARFID.
回避/限制性食物摄入障碍（ARFID）是《精神疾病诊断与统计手册》第5版（DSM-5）引入的一种饮食失调症，其患病率日益上升且治疗具有挑战性，主要影响儿童和青少年，成人病例报告有限。成人中这种疾病的罕见性导致误诊或漏诊，且治疗经验匮乏。
本报告详细描述了一例成人ARFID病例，患者因摄入玉米导致胃部损伤后对食物摄入产生恐惧，因胃痛而饮食受限，仅食用米粥。这种行为是由对饮食相关不良反应的恐惧所驱动。
基于临床症状评估、半结构化访谈以及包括PET/MRI扫描以排除继发疾病在内的全面检查，确诊为ARFID。ARFID是DSM-5中新引入的诊断，在成人中并不常见且病例数据稀少。将其与胃肠道疾病和其他精神疾病相鉴别对于准确诊断和针对性治疗至关重要。
在本文中，我们报告了一例成人ARFID病例的临床诊断、影像学表现、治疗及随访情况，强调了神经影像学在诊断和鉴别中的作用。同时评估了奥氮平、草酸艾司西酞普兰和氢溴酸氟西汀的治疗效果，为ARFID的诊断和管理提供临床指导。
