Avoidant/Restrictive Food Intake Disorder: Illness and Hospital Course in Patients Hospitalized for Nutritional Insufficiency
Avoidant/Restrictive Food Intake Disorder: Illness and Hospital Course in Patients Hospitalized for Nutritional Insufficiency
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DOI：
10.1016/j.jadohealth.2015.08.003
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发表时间：
2015-12-01
影响因子：
7.6
通讯作者：
Rome, Ellen S.
中科院分区：
文献类型：
--
作者：
Strandjord, Sarah E.;Sieke, Erin H.;Rome, Ellen S.
目的：回避/限制性食物摄入障碍（ARFID）是最近定义的精神障碍诊断和统计手册-5饮食障碍诊断，尚未在住院患者群体中进行广泛研究。本研究比较了住院的 ARFID 和神经性厌食症 (AN) 患者，包括表现、治疗反应和 1 年结果的差异。方法：我们对 2008 年至 2014 年间在学术医疗中心因急性医疗稳定而住院的 ARFID 和 AN 患者进行了回顾性图表审查。记录每位患者的数据，包括入院时、住院期间和出院后 1 年的特征，并在 ARFID 和 AN 患者之间进行比较。结果：就目前情况而言，ARFID 患者 (n = 41) 比 AN 患者 (n = 203) 更年轻，传统饮食失调行为较少，体重减轻、合并症和心动过缓也较少。在住院期间，尽管 ARFID 和 AN 患者的热量摄入量相似，但 ARFID 患者比 AN 患者依赖更多的肠内营养并且需要更长的住院时间（8 天与 5 天；p = .0006）。出院一年后，大约一半的 ARFID 和 AN 患者达到缓解标准（62% vs. 46%；p = .18），不到四分之一的患者需要重新入院（21% vs. 24%；p = .65）。结论：这项研究的结果揭示了住院饮食失调患者的一些差异，并强调需要对 ARFID 患者进行进一步研究，包括对疾病严重程度标志物和最佳再喂养方法的研究。 ARFID 和 AN 患者相似的缓解率和再入院率凸显了饮食失调治疗的成功和持续改进的需要，无论诊断如何。 (C) 2015 年青少年健康与医学协会。版权所有。
Purpose: Avoidant/restrictive food intake disorder (ARFID), a recently defined Diagnostic and Statistical Manual of Mental Disorders-5 eating disorder diagnosis, has not been extensively studied in the inpatient population. This study compares hospitalized ARFID and anorexia nervosa (AN) patients, including differences in presentation, treatment response, and 1-year outcomes.Methods: We conducted a retrospective chart review of ARFID and AN patients hospitalized between 2008 and 2014 for acute medical stabilization at an academic medical center. Data, including characteristics on admission, during hospitalization, and 1 year after discharge, were recorded for each patient and compared between ARFID and AN patients.Results: On presentation, ARFID patients (n = 41) were younger with fewer traditional eating disorder behaviors and less weight loss, comorbidity, and bradycardia than AN patients (n = 203). During hospitalization, although ARFID and AN patients had similar caloric intake, ARFID patients relied on more enteral nutrition and required longer hospitalizations than AN patients (8 vs. 5 days; p = .0006). One year after discharge, around half of ARFID and AN patients met criteria for remission (62% vs. 46%; p = .18), and less than one-quarter required readmission (21% vs. 24%; p = .65).Conclusions: The findings from this study reveal several differences in hospitalized eating disorder patients and emphasize the need for further research on ARFID patients, including research on markers of illness severity and optimal approaches to refeeding. Similar remission and readmission rates among ARFID and AN patients highlight both the success and the continued need for improvement in eating disorder treatment regardless of diagnosis. (C) 2015 Society for Adolescent Health and Medicine. All rights reserved.