Mental and Somatic Conditions in Children With the Broad Avoidant Restrictive Food Intake Disorder Phenotype

JAMA Pediatrics, Год журнала: 2025, Номер unknown

Опубликована: Фев. 17, 2025

Importance Avoidant restrictive food intake disorder (ARFID) is a feeding and eating characterized by limited variety and/or quantity of impacting physical health psychosocial functioning. Children with ARFID often present diverse psychiatric somatic symptoms therefore consult various pediatric subspecialties. Large-scale studies mapping coexisting conditions are, however, lacking. Objective To characterize the care needs youth ARFID. Design, Setting, Participants This cohort study used Child Adolescent Twin Study in Sweden (CATSS), combination inpatient specialized outpatient clinical diagnoses from Swedish National Patient Register. Data were collected July 2004 to April 2020, data analyzed September 2022 February 2024. Exposure Using composite measure derived parent or guardian reports register data, children broad phenotype occurring between ages 6 12 years identified, as well without Main Outcomes Measures From more than 1000 diagnostic International Classification Diseases ( ICD ) codes, mental within across chapters, number distinct per-person diagnoses, treatment days participants’ birth 18th birthdays specified (90 outcomes). Hazard ratios (HRs) incidence rate (IRRs) calculated. Results Of 30 795 CATSS participants, total 616 (2.0%) 179 identified. ARFID, 241 female (39.1%). Relative risks neurodevelopmental, gastrointestinal, endocrine metabolic, respiratory, neurological, allergic disorders substantially increased (eg, autism: HR, 9.7; 95% CI, 7.5-12.5; intellectual disability: 10.3; 7.6-13.9; gastroesophageal reflux disease: 6.7; 4.6-9.9; pituitary conditions: 5.6; 2.7-11.3; chronic lower respiratory diseases: 4.9; 2.4-10.1; epilepsy: 5.8; 4.1-8.2). was not associated elevated autoimmune illnesses obsessive-compulsive disorder. had significantly (IRR, 4.7; 4.0-5.4) longer hospital stays 5.5; 1.7-17.6) compared diagnosed condition earlier No sex-specific differences emerged. Conclusions Relevance yields broadest most detailed evidence largest sample date. Findings suggest complex pattern underscoring critical importance attention illness all specialties.

Язык: Английский

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Nutritional Factors and Therapeutic Interventions in Autism Spectrum Disorder: A Narrative Review

Children, Год журнала: 2025, Номер 12(2), С. 202 - 202

Опубликована: Фев. 8, 2025

Objective: To explore recent findings on how nutritional, gastrointestinal, social, and epigenetic factors interact in autism spectrum disorder, highlighting their implications for clinical management intervention strategies that could improve development quality of life affected children. Sources: Studies published from 2000 to 2024 the PubMed, Web Science, Scopus, Scielo, Lilacs, Google Scholar databases were collected. The process review adhered Search, Appraisal, Synthesis, Analysis framework. Summary findings: Children with disorder have restrictive eating habits often exhibit food selectivity either hyper- or hypo-sensory characteristics. This provides an overview literature diagnosis including involvement family members meals, sharing a healthy diet positive relationship food, importance exploring visual, olfactory, tactile experiences introducing new foods through play activities expand repertoire. Modifications microbiota gastrointestinal disorders may also be present are presented due frequent nutritional repercussions. medium long-term preferences behavior issues status discussed, given tendency children consume low-quality energy-dense foods, leading problems. Conclusions: feeding difficulties, especially selectivity, problems, changes can evolve micronutrient deficiencies, malnutrition obesity. describes evidence possible targets interventions aiming health disorder.

Язык: Английский

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Questioning the role of food addiction in pediatric obesity: Comment on An et al. (2025)

Obesity Research & Clinical Practice, Год журнала: 2025, Номер unknown

Опубликована: Март 1, 2025

Язык: Английский

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Eating Disorders

JAMA, Год журнала: 2025, Номер unknown

Опубликована: Март 6, 2025

Eating disorders are characterized by disturbances in eating behavior and occur worldwide, with a lifetime prevalence of 2% to 5%. They more common among females than males may be associated medical psychiatric complications, impaired functioning, decreased quality life. Common include anorexia nervosa, bulimia binge-eating disorder, avoidant/restrictive food intake disorder. These changes weight, electrolyte abnormalities (eg, hyponatremia, hypokalemia), bradycardia, reproductive hormones estradiol levels females), bone density. Individuals disorder have high rates depression (76.3% for 65.5% 49.5% nervosa) higher suicide attempts those without disorders. Anorexia nervosa is mortality rate 5.1 deaths per 1000 person-years (95% CI, 4.0-6.1), nearly 6 times that individuals the same age nervosa; 25% from suicide. First-line treatments nutritional support, psychotherapy, pharmacotherapy. Behaviorally focused therapies, including cognitive behavioral therapy, effective, especially Youth benefit family-based treatment parental oversight eating, resulting remission at 12 months 48.6% vs 34.3% individual (odds ratio, 2.08; 95% 1.07-4.03; P = .03). Fluoxetine other antidepressants decrease episodes binge even (fluoxetine placebo, standardized mean difference -0.24 [small effect size; -0.41 -0.08]). Antidepressants central nervous system stimulant lisdexamfetamine reduce frequency compared placebo (antidepressants -0.29 -0.51 -0.06]; Hedges g 0.57 [medium 0.28-0.86]). There currently no effective medications nervosa. serious or complications such as bradycardia suicidality should hospitalized treatment. Globally, affect 5% during their males. In addition weight changes, cause abnormalities, hormones, density, increased risk depression, anxiety, attempts.

Язык: Английский

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Development and Management of Avoidant/Restrictive Food Intake Disorder and Food Neophobia in Pediatric Patients with Food Allergy: A Comprehensive Review

Nutrients, Год журнала: 2024, Номер 16(17), С. 3034 - 3034

Опубликована: Сен. 8, 2024

Avoidant/Restrictive Food Intake Disorder (ARFID) and food neophobia present significant challenges in pediatric healthcare, particularly among children with allergies (FAs). These eating disorders, characterized by the persistent avoidance or restriction of food, can lead to severe nutritional deficiencies psychosocial impairments. The presence FAs further complicates these behaviors, as fear allergic reactions exacerbates restrictive patterns. This comprehensive review synthesizes current knowledge on ARFID neophobia, focusing their definitions, characteristics, unique they context FAs. explores critical role healthcare professionals, especially nurses, integrating psychological clinical care improve outcomes for affected children. A multidisciplinary approach, including Cognitive Behavioral Therapy (CBT) Family-Based (FBT), is emphasized essential addressing complex needs patients. also highlights need standardized treatment protocols research long-term aiming enhance therapeutic strategies family support systems. Effective management requires a holistic integrated approach mitigate profound impacts child’s growth, development, overall well-being.

Язык: Английский

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Training group for parents of patients with pediatric avoidant/restricted food intake disorder sensory-based avoidance: feasibility and acceptability

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Авг. 13, 2024

Background We aimed to assess the feasibility, acceptability, treatment satisfaction and preliminary efficacy of a training group for parents patients with avoidant/restrictive food intake disorder (ARFID). The objective our is enable families co-construct knowledge strategies that will empower them improve children's flexibility, dietary eating in social situations. Method 18 children (aged 5–14 years) ARFID sensory-based avoidance participated 2-day session group. Feasibility acceptability were assessed by calculating enrollment, attendance attrition. Therapeutic alliance perception care benefit Helping Alliance Questionnaire-11 (HAQ-11S) Consumer Satisfaction Questionnaire (CSQ-8), was Clinical Global Impression Severity (CGI-S) Improvement (CGI-I) questionnaires administered pre- posttreatment. Results Of 26 eligible families, (69%) participating all except 2 (11%) completed sessions. Both invited participate, but we observed little involvement from fathers (83% mothers attending sessions alone). Parents rated as highly satisfactory, significant increases posttreatment HAQ-11S CSQ-8 (p < .001). Significantly decreased CGI severity scores .003). Qualitative evaluation suggested improved symptom understanding, increased parental empowerment isolation. Discussion findings this study provide evidence short parent-based associated high levels engagement satisfaction, isolation, enhanced competence child flexibility. Many are not able access appropriate care, enhancing parents’ functions daily life may patients’ long-term trajectories.

Язык: Английский

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The Challenges of Avoidant/Restrictive Food Intake Disorder and Autism Spectrum Disorder Comorbidity: A Narrative Update of Course and Outcomes

Current Treatment Options in Psychiatry, Год журнала: 2024, Номер unknown

Опубликована: Окт. 25, 2024

Язык: Английский

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