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J Adolesc Health. 2014 Jul;55(1):49-52. doi: 10.1016/j.jadohealth.2013.11.013. Epub 2014 Feb 5.

Characteristics of avoidant/restrictive food intake disorder in children and adolescents: a "new disorder" in DSM-5.

Author information

1
Division of Adolescent Medicine, Cohen Children's Medical Center, North Shore-Long Island Jewish Health System, New Hyde Park, New York. Electronic address: fisher@nshs.edu.
2
Departments of Pediatrics, Internal Medicine, and Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan.
3
Division of Adolescent Medicine and Eating Disorders, Penn State Hershey Children's Hospital, Hershey, Pennsylvania.
4
Department of Pediatrics, Oakland University William Beaumont School of Medicine, Division of Adolescent Medicine, Beaumont Children's Hospital, Royal Oak, Michigan.
5
Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
6
Center for Adolescent Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio.
7
Division of Adolescent and Young Adult Health, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee.
8
Division of Adolescent Medicine, Cohen Children's Medical Center, North Shore-Long Island Jewish Health System, New Hyde Park, New York.
9
Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, New York.

Abstract

PURPOSE:

To evaluate the DSM-5 diagnosis of Avoidant/Restrictive Food Intake Disorder (ARFID) in children and adolescents with poor eating not associated with body image concerns.

METHODS:

A retrospective case-control study of 8-18-year-olds, using a diagnostic algorithm, compared all cases with ARFID presenting to seven adolescent-medicine eating disorder programs in 2010 to a randomly selected sample with anorexia nervosa (AN) and bulimia nervosa (BN). Demographic and clinical information were recorded.

RESULTS:

Of 712 individuals studied, 98 (13.8%) met ARFID criteria. Patients with ARFID were younger than those with AN (n = 98) or BN (n = 66), (12.9 vs. 15.6 vs. 16.5 years), had longer durations of illness (33.3 vs. 14.5 vs. 23.5 months), were more likely to be male (29% vs. 15% vs. 6%), and had a percent median body weight intermediate between those with AN or BN (86.5 vs. 81.0 and 107.5). Patients with ARFID included those with selective (picky) eating since early childhood (28.7%); generalized anxiety (21.4%); gastrointestinal symptoms (19.4%); a history of vomiting/choking (13.2%); and food allergies (4.1%). Patients with ARFID were more likely to have a comorbid medical condition (55% vs. 10% vs. 11%) or anxiety disorder (58% vs. 35% vs. 33%) and were less likely to have a mood disorder (19% vs. 31% vs. 58%).

CONCLUSIONS:

Patients with ARFID were demographically and clinically distinct from those with AN or BN. They were significantly underweight with a longer duration of illness and had a greater likelihood of comorbid medical and/or psychiatric symptoms.

KEYWORDS:

5th Edition of the diagnostic and statistical Manual (DSM-5); Anorexia nervosa (AN); Avoidant/Restrictive food intake disorder (ARFID); Bulimia nervosa (BN); Children and adolescents

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