Prevalence and correlates of psychiatric comorbidities in children and adolescents with full and subthreshold avoidant/restrictive food intake disorder
Prevalence and correlates of psychiatric comorbidities in children and adolescents with full and subthreshold avoidant/restrictive food intake disorder
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DOI：
10.1002/eat.23191
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发表时间：
2019-11-08
影响因子：
5.5
通讯作者：
Thomas, Jennifer J.
中科院分区：
文献类型：
--
作者：
Kambanis, P. Evelyna;Kuhnle, Megan C.;Thomas, Jennifer J.
目的研究完全和阈下回避/限制性食物摄入障碍（ARFID）患者中的治疗和非治疗寻求者的精神病共病和自杀倾向的当前和终生患病率。我们还试图检查三个DSM-5 ARFID配置文件之间的独特关联（即，感官敏感性、对令人厌恶的后果的恐惧以及对食物或进食缺乏兴趣）以及精神病诊断和自杀倾向的特定类别。方法：我们对74名患有完全或亚阈值ARFID的儿童和青少年进行了结构化临床访谈，以评估是否存在共病精神病诊断、自杀倾向以及三种ARFID特征的严重程度。结果近一半的样本（45%）符合当前共病精神病诊断的标准，超过一半（53%）符合终身共病诊断的标准。共有8%的人赞同当前自杀倾向，14%的人赞同终身自杀倾向。感觉灵敏度的严重程度与神经发育、破坏性和行为障碍类别、焦虑、强迫和创伤相关障碍类别以及抑郁和双相情感障碍类别中的共病障碍的几率更大唯一相关。厌恶性后果恐惧的严重程度与焦虑、强迫和创伤相关障碍类别中的障碍发生率更高相关。讨论我们的研究结果强调了ARFID和相关表现个体的精神病理学严重程度，也强调了特定ARFID特征和其他精神疾病之间共享精神病理学的可能性，这些精神疾病代表了转诊断结构（例如，回避行为），这可能是相关的治疗目标。
Objective We aimed to characterize the current and lifetime prevalence of comorbid psychiatric diagnoses and suicidality in treatment- and nontreatment-seeking individuals with full and subthreshold avoidant/restrictive food intake disorder (ARFID). We also sought to examine unique associations between the three DSM-5 ARFID profiles (i.e., sensory sensitivity, fear of aversive consequences, and lack of interest in food or eating) and specific categories of psychiatric diagnoses and suicidality. Method We conducted structured clinical interviews with 74 children and adolescents with full or sub threshold ARFID to assess the presence of comorbid psychiatric diagnoses, suicidality, and the severity of each of the three ARFID profiles. Results Nearly half of the sample (45%) met criteria for a current comorbid psychiatric diagnosis, and over half (53%) met criteria for a lifetime comorbid diagnosis. A total of 8% endorsed current suicidality and 14% endorsed lifetime suicidality. Severity in the sensory sensitivity profile was uniquely associated with greater odds of comorbid disorders in the neurodevelopmental, disruptive, and conduct disorders category; the anxiety, obsessive-compulsive, and trauma-related disorders category; and the depressive and bipolar-related disorders category. Severity in the fear of aversive consequences profile was associated with greater odds of disorders in the anxiety, obsessive-compulsive, and trauma-related disorders category. Discussion Our findings underscore the severity of psychopathology among individuals with ARFID and related presentations, and also highlight the potential that shared psychopathology between specific ARFID profiles and other psychiatric disorders represent transdiagnostic constructs (e.g., avoidant behavior) that may be relevant treatment targets.