Birth-related, medical, and diagnostic characteristics in younger versus older children with avoidant/restrictive food intake disorder (ARFID)

Journal of Eating Disorders · 7 authors, 5 centres

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TL;DR

This interview-based study compared 51 treatment-seeking children with ARFID, finding that younger patients (0-5 years) had more preterm births and pre- and perinatal complications, while older patients (6-17 years) had more mental comorbidities.

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Medical records and diagnostic interviews revealed that younger patients were significantly more likely to have been born preterm, experience pre- and perinatal complications, and undergo postnatal invasive procedures. They also presented with significantly more physical comorbidities, particularly congenital anomalies. Conversely, older patients had significantly higher rates of mental comorbidities, especially mood disorders. Exploratory analyses of ARFID diagnostic criteria and main presentations showed medium-sized differences between age groups, with sensory sensitivity being the most common presentation across both. The findings suggest age-specific characteristics that could be relevant for diagnosis and treatment planning.

STUDY TYPE

cohort

SPECIALTY

pediatrics

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ORIGINAL PAPER

PMC10601262

Birth-related, medical, and diagnostic characteristics in younger versus older children with avoidant/restrictive food intake disorder (ARFID)

Journal of Eating Disorders

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ABSTRACT

Background Although avoidant/restrictive food intake disorder (ARFID) presents the replacement and extension of feeding disorders of infancy and childhood, previous research into ARFID concentrated mainly on older patients. While birth-related characteristics play an etiologic role in feeding disorders, virtually nothing is known so far in ARFID. Therefore, the first aim of the study was to identify differences in birth-related characteristics in younger vs. older children with ARFID. Second, differences in physical and mental comorbidities, and third, diagnostic features between age groups were analysed. Methods Among N = 51 in- and outpatient treatment-seeking patients, n = 23 patients aged 0–5 years (30% girls) and n = 28 patients aged 6–17 years (57% girls), with an interview-based diagnosis of ARFID were included. Data on the pre- and perinatal period and mental and physical comorbidities were derived from patients’ medical records, while diagnostic criteria, main ARFID presentation, and sociodemographic variables were collected through diagnostic interview. Results Significantly, younger patients with ARFID were born more often preterm and had more pre- and perinatal complications and a higher incidence of postnatal invasive procedures. Patients with ARFID aged 0–5 years presented significantly more physical comorbidities and conditions, especially congenital anomalies, while mental comorbidities, especially mood disorders, were significantly more common in patients with ARFID aged 6–17 years. No age differences were found for the distribution of diagnostic criteria and main ARFID presentation. Conclusion This is the first study which aimed to identify age-specific characteristics in patients with ARFID with potential relevance for diagnosis and treatment. Especially birth-related complications, including invasive procedures postnatally, may be associated with developing ARFID, highlighting the importance of a closer view on these potential risk factors of the disorder. Future research with longitudinal design and larger samples may allow more detailed information on further age-specific associations, symptom trajectories, and age-specific risk factors for ARFID. Supplementary Information The online version contains supplementary material available at 10.1186/s40337-023-00908-7.

CITATION EXPORT

Luise Brosig, Dominik Düplois, Andreas Hiemisch et al.. Birth-related, medical, and diagnostic characteristics in younger versus older children with avoidant/restrictive food intake disorder (ARFID). Journal of Eating Disorders. (2023). https://doi.org/10.1186/s40337-023-00908-7

AUTHORS

7 · 5 CENTRES

Luise Brosig, Dominik Düplois, Andreas Hiemisch, Wieland Kiess, Anja Hilbert, Franziska Schlensog-Schuster, Ricarda Schmidt

1https://ror.org/03s7gtk40grid.9647.c0000 0004 7669 9786Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center Adiposity Diseases, Leipzig University Medical Center, Stephanstrasse 9a, 04103 Leipzig, Germany
2https://ror.org/03s7gtk40grid.9647.c0000 0004 7669 9786LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany
3https://ror.org/03s7gtk40grid.9647.c0000 0004 7669 9786Hospital for Children and Adolescents, Center for Pediatric Research, Leipzig University Medical Center, Liebigstrasse 20a, 04103 Leipzig, Germany
4https://ror.org/03s7gtk40grid.9647.c0000 0004 7669 9786Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Leipzig University Medical Center, Liebigstrasse 20a, 04103 Leipzig, Germany
5https://ror.org/02k7v4d05grid.5734.50000 0001 0726 5157University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland