<p>An Inpatient Observational Study: Characteristics And Outcomes Of Avoidant/Restrictive Food Intake Disorder (ARFID) In Children And Adolescents In Japan</p>

Abstract

PurposeTo determine the clinical characteristics and course of severe avoidant/restrictive food intake disorder (ARFID) in hospitalized children and adolescents and compare them with those of patients with restricting-type anorexia nervosa (R-AN).Patients and methodsWe conducted a retrospective chart review of inpatients diagnosed with ARFID or R-AN based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, at Jichi Children’s Medical Center Tochigi between April 1, 2007 and March 31, 2017. We compared the characteristics of the ARFID and R-AN patients at admission, during hospitalization, and after discharge.ResultsBoth the ARFID (n=13) and R-AN (n=79) patients required hospitalization for their medically unstable state. The features of ARFID group included concern about the aversive consequences of eating and avoidance of eating due to sensory concerns. Significant differences were found at admission between ARFID and R-AN groups in age (10.7 vs 12.7 years), family history of mental disorders (46.2% vs 17.7%), comorbid developmental disorders (6 vs 3 cases), and the time from onset to admission (3.9 vs 6.3 months). The body weight status, % ideal body weight (%IBW), % expected body weight (%EBW), <75% IBW rate, and <75% EBW rate did not differ significantly between the two groups at admission or discharge. The duration of post-discharge outpatient follow-up treatment did not differ significantly between ARFID and R-AN groups (15.3 vs 18.4 months); however, ARFID group recovery rate was significantly higher than that of R-AN group (77% vs 43%). The reasons that the patients with ARFID had significantly better outcomes than the R-AN patients remain unclear. Compared to those in previous studies, the present patients were younger and demonstrated better outcomes. Our results indicate that the body weight status is similar between ARFID and R-AN patients, but the ARFID patients achieved better outcomes.ConclusionThese findings suggest that early onset in childhood, early disease recognition, and early intervention are important factors for achieving better outcomes for patients with ARFID.

The changing profile of eating disorders and related sociocultural factors in Japan between 1700 and 2020: A systematic scoping review

“…They also reported significantly better treatment outcomes than the AN group (Nakai et al, 2017). These findings were confirmed by another study, in which researchers conducted a retrospective chart review of hospitalized children and adolescents diagnosed with ARFID and AN restricting‐subtype (AN‐R) (Kurotori et al, 2019). The recovery rate of the ARFID group was significantly higher than that of the AN‐R group.…”

Avoidant Restrictive Food Intake Disorder—More Than Just Picky Eating: A Case Discussion and Literature Review

“…If they are admitted for ARFID on an eating disorder unit, they may have the opportunity to participate in group therapy and individual or family counseling. 5 They may also have opportunities to access psychoeducational programs and nutritional support with a dietitian or nutritionist, and it is recommended to continue with these therapies on an outpatient basis. 5 The individual therapy may include ABA, CBT, or exposure therapy, depending on the patient's need.…”

“…5 They may also have opportunities to access psychoeducational programs and nutritional support with a dietitian or nutritionist, and it is recommended to continue with these therapies on an outpatient basis. 5 The individual therapy may include ABA, CBT, or exposure therapy, depending on the patient's need. ABA includes altering the patient's environment to increase the likelihood that they will be able perform the desired task of "eating food."…”

“…2 The demographic characteristics also varied depending on the location of the study and the sample population size. [1][2][3][4][5][6] Symptom presentation for patients with ARFID is individualistic in nature, but each patient described in the studies reviewed met at least 1 of the diagnostic criteria from the DSM-V. However, because the symptoms are so variable, ARFID may be misdiagnosed or not diagnosed, leading to increased hopelessness or frustration for the patient and their family members.…”

“…Avoidant restrictive food intake disorder (ARFID) was added to the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) in 2013 after previously being referred to as "selective eating" or "feeding disorders of infancy or early childhood." 1 AFRID affects more males than females, [1][2][3][4][5][6] and whites are affected by ARFID more than minorities. 2,3,6 Most of the research on ARFID is on children, with prevalence estimates ranging from 3% to 23%; therefore, it is not well known how prevalent ARFID is in adults.…”