Prevalence and Characterization of Avoidant Restrictive Food Intake Disorder in a Pediatric Population

Sader, Michelle; Harris, Holly A.; Waiter, Gordon D.; Jackson, Mike; Voortman, Trudy; Jansen, Pauline W.; Williams, Justin H. G.

doi:10.1016/j.jaacop.2023.05.001

Cited by 6 publications

(2 citation statements)

References 48 publications

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“…In a general population sample using a similar procedure to identify the ARFID phenotype (n=183 with ARFID), significantly more OCD symptoms were reported for the ARFID group. 25 However, the effect size was small and the statistical power was greater due to the use of a parent-reported continuous measure (rather than clinical diagnoses in the current study).…”

Section: Discussionmentioning

confidence: 71%

Co-existing mental and somatic conditions in Swedish children with the avoidant restrictive food intake disorder phenotype

Wronski,

Kuja-Halkola,

Hedlund

et al. 2024

Preprint

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Background: Avoidant restrictive food intake disorder (ARFID) is a feeding and eating disorder, characterized by limited variety and/or quantity of food intake impacting physical health and psychosocial functioning. Children with ARFID often present with a range of psychiatric and somatic symptoms, and therefore consult various pediatric subspecialties; large-scale studies mapping comorbidities are however lacking. To characterize health care needs of people with ARFID, we systematically investigated ARFID-related mental and somatic conditions in 616 children with ARFID and >30,000 children without ARFID. Methods: In a Swedish twin cohort, we identified the ARFID phenotype in 6-12-year-old children based on parent-reports and register data. From >1,000 diagnostic ICD-codes, we specified mental and somatic conditions within/across ICD-chapters, number of distinct per-person diagnoses, and inpatient treatment days between birth and 18th birthday (90 outcomes). Hazard ratios (HR) and incidence rate ratios (IRR) were calculated. Findings: Relative risks of neurodevelopmental, gastrointestinal, endocrine/metabolic, respiratory, neurological, and allergic disorders were substantially increased in ARFID (e.g., autism HR[CI95%]=9.7[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]). ARFID was not associated with elevated risks of autoimmune illnesses and obsessive-compulsive disorder. Children with ARFID had a significantly higher number of distinct mental diagnoses (IRR[CI95%]=4.7[4.0-5.4]) and longer duration of hospitalizations (IRR[CI95%]=5.5[1.7-17.6]) compared with children without ARFID. Children with ARFID were diagnosed earlier with a mental condition than children without ARFID. No sex-specific differences emerged. Interpretation: This study yields the broadest and most detailed evidence of co-existing mental and somatic conditions in the largest sample of children with ARFID to date. Findings suggest a complex pattern of health needs in youth with ARFID, underscoring the critical importance of attention to the illness across all pediatric specialties. Funding: Fredrik and Ingrid Thurings Foundation, Mental Health Foundation.

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Section: Discussionmentioning

confidence: 71%

Co-existing mental and somatic conditions in Swedish children with the avoidant restrictive food intake disorder phenotype

Wronski,

Kuja-Halkola,

Hedlund

et al. 2024

Preprint

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“…18,32 Similarly, higher odds of OCD and sleep problems is supported by prior research. 34,35 A register-based study on the same sample did not find a significantly increased risk of clinical diagnoses of OCD in the ARFID group, which might be explained by lower statistical power in using registered diagnoses compared to using parent reports. 11 Additionally, in Sweden, OCD is often treated in primary care and that study did not include diagnoses received in primary care.…”

Section: Discussionmentioning

confidence: 79%

Neurodevelopmental and psychiatric conditions in 600 Swedish Children with the ARFID phenotype

Nyholmer,

Wronski,

Hog

et al. 2024

Preprint

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Objective: Avoidant restrictive food intake disorder (ARFID) is a feeding and eating disorder characterized by extremely restricted dietary variety and/or quantity resulting in serious consequences for physical health and psychosocial functioning. ARFID often co-occurs with neurodevelopmental conditions (NDCs) and psychiatric conditions, but previous data are mostly limited to small clinical samples examining a narrow range of conditions. Here, we examined NDCs and psychiatric conditions in a large, population-based group of children with ARFID. Method: In a sample of 30,795 children born 1992-2008 in Sweden, ARFID was assessed using parent reports and clinical diagnoses from national health registers. Parents further reported symptoms of NDCs and psychiatric conditions at child age 9 or 12 years. We conducted regressions for symptom scores and screening diagnoses (identified using validated cut offs) on ARFID and examined interactions with sex. Results: Children with ARFID had significantly increased odds of all 17 screening diagnoses with odds ratios ranging from 3.3 for visual hallucinations to 13.7 for autism (all p<.0001). The most common NDCs were oppositional defiant disorder (19.4%), ADHD (16.9%), tic disorders (14.8%), and autism (12.1%). Among psychiatric conditions, separation anxiety disorder (29.0%) and sleep problems (20.0%) had the highest prevalence. We did not find any sex-specific differences in co-occurring conditions. Conclusion: This study highlights the co-occurrence of a broad range of NDCs and psychiatric conditions with ARFID in a large, non-clinical cohort. Our findings underscore that children with ARFID face significant burden from multiple co-existing conditions which should be considered during assessment and treatment.

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Exploring Family Care Journeys to Inform Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder and Somatic Symptom Disorders

Young,

Boerner,

Marshall

et al. 2024

Cognitive and Behavioral Practice

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Prevalence and Characterization of Avoidant Restrictive Food Intake Disorder in a Pediatric Population

Cited by 6 publications

References 48 publications

Co-existing mental and somatic conditions in Swedish children with the avoidant restrictive food intake disorder phenotype

Co-existing mental and somatic conditions in Swedish children with the avoidant restrictive food intake disorder phenotype

Neurodevelopmental and psychiatric conditions in 600 Swedish Children with the ARFID phenotype

Exploring Family Care Journeys to Inform Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder and Somatic Symptom Disorders

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