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日本儿童回避/限制性食物摄入障碍的预后及其与自闭症谱系障碍的关系。

Avoidant/restrictive food intake disorder prognosis and its relation with autism spectrum disorder in Japanese children.

作者信息

Tanaka Chie, Okada Ayumi, Hanzawa Mana, Fujii Chikako, Shigeyasu Yoshie, Sugihara Akiko, Horiuchi Makiko, Yorifuji Takashi, Tsukahara Hirokazu

机构信息

Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Clinical Psychology Section, Department of Medical Support, Okayama University Hospital, Okayama, Japan.

出版信息

Pediatr Int. 2025 Jan-Dec;67(1):e70040. doi: 10.1111/ped.70040.

Abstract

BACKGROUND

There is a lack of reported clinical factors associated with the outcomes of children and adolescents with avoidant/restrictive food intake disorder (ARFID) in Japan. This study aimed to identify these clinical factors and explore the relationship between ARFID and autism spectrum disorder (ASD).

METHODS

This retrospective study analyzed data from 48 Japanese children and adolescents with ARFID who visited Okayama University Hospital between January 2011 and March 2022. Clinical characteristics were assessed using medical records and natural history questionnaires. The study compared patients with good and poor prognosis groups and used multiple logistic regression analysis to determine factors influencing prognosis.

RESULTS

The study included 33 patients with good prognoses and 15 with poor prognoses. Comorbid ASD was more prevalent in the poor prognosis group (60%) compared to the good prognosis group (21%). Additionally, more than half of the ARFID patients with comorbid ASD were initially undiagnosed. Multivariate analysis revealed that older age at first visit (p = 0.022) and comorbid ASD (p = 0.022) were statistically significant factors associated with poor prognosis in ARFID patients. There were no significant differences in body mass index standard deviation score and maximal weight loss between the two groups.

CONCLUSIONS

The poor prognosis group had a higher prevalence of comorbid ASD diagnoses. Therefore, it is crucial to evaluate patient's developmental characteristics early in treatment and consider these characteristics throughout the course of care.

摘要

背景

在日本,关于回避/限制性食物摄入障碍(ARFID)儿童和青少年的预后相关临床因素的报道较少。本研究旨在确定这些临床因素,并探讨ARFID与自闭症谱系障碍(ASD)之间的关系。

方法

这项回顾性研究分析了2011年1月至2022年3月期间就诊于冈山大学医院的48例日本ARFID儿童和青少年的数据。使用病历和自然病史问卷评估临床特征。研究比较了预后良好和预后不良的患者组,并使用多元逻辑回归分析来确定影响预后的因素。

结果

该研究包括33例预后良好的患者和15例预后不良的患者。与预后良好组(21%)相比,合并ASD在预后不良组中更为普遍(60%)。此外,超过一半合并ASD的ARFID患者最初未被诊断出来。多变量分析显示,首次就诊时年龄较大(p = 0.022)和合并ASD(p = 0.022)是ARFID患者预后不良的统计学显著相关因素。两组之间的体重指数标准差评分和最大体重减轻没有显著差异。

结论

预后不良组合并ASD诊断的患病率较高。因此,在治疗早期评估患者的发育特征并在整个护理过程中考虑这些特征至关重要。

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