Incidence and Age- and Sex-Specific Differences in the Clinical Presentation of Children and Adolescents With Avoidant Restrictive Food Intake Disorder

Abstract

IMPORTANCETo our knowledge, this is the first pediatric surveillance study of children and adolescents with avoidant restrictive food intake disorder (ARFID).OBJECTIVES To examine the incidence and age-and sex-specific differences in the clinical presentation of ARFID in children and adolescents in Canada.

What do we know about the epidemiology of avoidant/restrictive food intake disorder in children and adolescents? A systematic review of the literature

“…This is supported by findings from this review, with 21%-28% of children with ASD at high-risk of ARFID (Koomar et al, 2021;Nygren et al, 2021) and the prevalence of ASD among children with ARFID ranging from 8.2% to 54.75% (Dinkler et al, 2022b;Eddy et al, 2015;Farag et al, 2022;Katzman et al, 2021;Nicely et al, 2014;Wong et al, 2022). In terms of medical comorbidity, two studies reported that 45%-51% of patients with ARFID had medical symptoms (Fisher et al, 2014;Katzman et al, 2021) and 6 studies were conducted in clinical contexts where all patients presented with physical or medical symptoms (Bertrand et al, 2021;Eddy et al, 2015;Goldberg et al, 2020;Murray et al, 2022;Schöffel et al, 2021;Venema et al, 2022). Comorbidity with gastrointestinal (GI) symptoms or disorders was reported in 19.4%-43.8% of patients with ARFID (Fisher et al, 2014(Fisher et al, , 2015Krom et al, 2019).…”

“…One study took place in the Middle East (Iron‐Segev et al., 2022) and six in East Asian countries: four in Japan (Dinkler et al., 2022a, 2022b; Seike et al., 2016a, 2016b), one in Taiwan (Chen et al., 2020) and one in Singapore (Wong et al., 2022). The majority ( n = 21) of studies focussed on clinical populations (Bertrand et al., 2021; Cooney et al., 2018; Eddy et al., 2015; Farag et al., 2022; Fisher et al., 2014, 2015; Forman et al., 2014; Goldberg et al., 2020; Katzman et al., 2021; Koomar et al., 2021; Krom et al., 2019; Murray et al., 2022; Nicely et al., 2014; Norris et al., 2014; Nygren et al., 2021; Ornstein et al., 2013; Pinhas et al., 2017; Schöffel et al., 2021; Venema et al., 2022; Williams et al., 2015; Wong et al., 2022) with many drawing on samples from adolescent eating disorders services or feeding clinics ( n = 11) (Cooney et al., 2018; Farag et al., 2022; Fisher et al., 2014, 2015; Forman et al., 2014; Krom et al., 2019; Nicely et al., 2014; Norris et al., 2014; Ornstein et al., 2013; Williams et al., 2015; Wong et al., 2022) and utilising retrospective chart review methodology ( n = 13) (Cooney et al., 2018; Eddy et al., 2015; Fisher et al., 2014; Krom et al., 2019; Murray et al., 2022; Nicely et al., 2014; Norris et al., 2014; Nygren et al., 2021; Ornstein et al., 2013; Schöffel et al., 2021; Venema et al., 2022; Williams et al., 2015; Wong et al., 2022). All studies were cross‐sectional in design and ARFID diagnosis used the DSM‐5 or instrum...…”

The Polish Version of the Avoidant/Restrictive Food Intake Disorder Questionnaire—Parents Report (ARFID-Q-PR) and the Nine Items Avoidant/Restrictive Food Intake Disorder Screen—Parents Report (NIAS-PR): Maternal Perspective

“…Three patterns of ARFID restrictive eating have consistently been described, in both community and clinical samples: selective/neophobic (i.e., “picky” eating), poor appetite or limited interest in food, and fear of aversive consequences from eating [ 5 , 6 , 7 ]. Although largescale population prevalence estimates are not available, ARFID has been shown to be common in both community and clinical pediatric samples [ 5 , 8 , 9 ]. The short history of research on ARFID provides important descriptive data, but it is still insufficient for understanding its specifics and planning effective forms of treatment to patients and their families.…”

“…Some presentations of ARFID, particularly the selective/neophobic presentation, almost invariably begin early in development, becoming increasingly impairing when they persist beyond the normative stage of neophobia, which occurs at the age of 2 to 6 [ 10 , 17 ]. Indeed, one largescale epidemiological study from Canada found that older children with ARFID generally had more severe medical and psychological morbidity than younger children [ 8 ]. Common comorbidities of ARFID include neurodevelopmental disorders (e.g., autism), sensory integration disorders, alexithymia, intellectual disability, difficult temperament, high levels of externalization and internalization, psychomotor hyperactivity, anxiety disorders, obsessive-compulsive disorders, depressive disorders, suicide attempts and self-harm [ 13 , 15 , 18 , 19 , 20 , 21 , 22 ].…”

Symptoms of Avoidant/Restrictive Food Intake Disorder among 2–10-Year-Old Children: The Significance of Maternal Feeding Style and Maternal Eating Disorders

“…It has also been proven that feeding and eating disorders in children are related to their difficult temperament and an increased level of physiological arousal [ 17 , 18 , 19 ]. A recent study by Katzman et al [ 20 ] found that sex and age are important in the manifestation of ARFID symptoms: boys more often than girls refuse to eat because of the sensory properties of food, and younger children (5–10 years old) more often than older ones have sensory reluctance and a lack of interest in eating. There is also evidence of genetic determinants of appetite regulation and taste preferences in early life [ 21 ].…”