Prevalence of DSM-5 Avoidant/Restrictive Food Intake Disorder in a Pediatric Gastroenterology Healthcare Network
Prevalence of DSM-5 Avoidant/Restrictive Food Intake Disorder in a Pediatric Gastroenterology Healthcare Network
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DOI：
10.1002/eat.22350
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发表时间：
2015-07-01
影响因子：
5.5
通讯作者：
Becker, Anne E.
中科院分区：
文献类型：
--
作者：
Eddy, Kamryn T.;Thomas, Jennifer J.;Becker, Anne E.
Objective: Few published studies have evaluated the clinical utility of new diagnostic criteria for avoidant/restrictive food intake disorder (ARFID), a DSM-5 reformulation of feeding and eating disorder of infancy or early childhood. We examined the prevalence of ARFID and inter-rater reliability of its diagnostic criteria in a pediatric gastrointestinal sample.Method: We conducted a retrospective chart review of 2,231 consecutive new referrals (ages 8-18 years) to 19 Boston-area pediatric gastroenterology clinics for evidence of DSM-5 ARFID.Results: We identified 33 (1.5%) ARFID cases; 22 of whom (67%) were male. Most were characterized by insufficient intake/little interest in feeding (n = 19) or limited diet due to sensory features of the food (n = 7). An additional 54 cases (2.4%) met one or more ARFID criteria but there was insufficient information in the medical record to confer or exclude the diagnosis. Diagnostic agreement between coders was adequate (kappa = 0.72). Common challenges were (i) distinguishing between diagnoses of ARFID and anorexia nervosa or anxiety disorders; (ii) determination of whether the severity of the eating/feeding disturbance was sufficient to warrant diagnosis in the presence of another medical or psychiatric disorder; and (iii) assessment of psychosocial impairment related to eating/feeding problems.Discussion: In a pediatric treatment-seeking sample where ARFID features were common, cases meeting full criteria were rare, suggesting that the diagnosis is not over-inclusive even in a population where eating/feeding difficulties are expected. (C) 2014 Wiley Periodicals Inc.
