The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traitsResearch in context
Summary: Background: Avoidant restrictive food intake disorder (ARFID) is a new eating disorder with a heterogeneous clinical presentation. It is unclear which patient characteristics contribute to its heterogeneity. Methods: To identify these patient characteristics, we performed symptom-level cor...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S258953702300367X |
| _version_ | 1797729875351568384 |
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| author | Rosie Watts Tanith Archibald Pippa Hembry Maxine Howard Cate Kelly Rachel Loomes Laura Markham Harry Moss Alfonce Munuve Anca Oros Amy Siddall Charlotte Rhind Mohammed Uddin Zain Ahmad Rachel Bryant-Waugh Christopher Hübel |
| author_facet | Rosie Watts Tanith Archibald Pippa Hembry Maxine Howard Cate Kelly Rachel Loomes Laura Markham Harry Moss Alfonce Munuve Anca Oros Amy Siddall Charlotte Rhind Mohammed Uddin Zain Ahmad Rachel Bryant-Waugh Christopher Hübel |
| author_sort | Rosie Watts |
| collection | DOAJ |
| description | Summary: Background: Avoidant restrictive food intake disorder (ARFID) is a new eating disorder with a heterogeneous clinical presentation. It is unclear which patient characteristics contribute to its heterogeneity. Methods: To identify these patient characteristics, we performed symptom-level correlation and driver-level regression analyses in our cross-sectional study in up to 261 ARFID patients (51% female; median age = 12.7 years) who were assessed at the Maudsley Centre for Child and Adolescent Eating Disorders, London between November 2019 and July 2022. Findings: Symptoms across the three drivers 1) avoidance based on sensory characteristics of food; 2) apparent lack of interest in eating; and 3) concern about aversive consequences positively correlated with each other. Patients' anxiety traits showed the greatest positive correlations with symptoms of concern about aversive consequences of eating. Patient sex was not significantly associated with any of the three ARFID drivers. Patients with comorbid autism spectrum disorder (ASD; 28%) showed more food-related sensory sensitivities (RR = 1.26) and greater lack of interest in eating (RR = 1.18) than those of patients without ASD (49%). Interpretation: In our clinical sample, the ARFID drivers occurred together and did not show clinically meaningful differences between the sexes. ASD may accentuate food-related sensory sensitivities and lack of interest, but may not drive a completely different symptom presentation. ARFID is multi-faceted and heterogenous, requiring a comprehensive multidisciplinary assessment to sufficiently understand the drivers of the restrictive eating behaviour. Results need replication in larger samples with more statistical power. Funding: None. |
| first_indexed | 2024-03-12T11:36:01Z |
| format | Article |
| id | doaj.art-ec0e2702317d432dbef99026505cee2a |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-03-12T11:36:01Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-ec0e2702317d432dbef99026505cee2a2023-09-01T05:03:00ZengElsevierEClinicalMedicine2589-53702023-09-0163102190The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traitsResearch in contextRosie Watts0Tanith Archibald1Pippa Hembry2Maxine Howard3Cate Kelly4Rachel Loomes5Laura Markham6Harry Moss7Alfonce Munuve8Anca Oros9Amy Siddall10Charlotte Rhind11Mohammed Uddin12Zain Ahmad13Rachel Bryant-Waugh14Christopher Hübel15Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United KingdomSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United KingdomAvoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United KingdomSocial, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom; Avoidant Restrictive Food Intake Disorder Outpatient Service, Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, United Kingdom; National Centre for Register-based Research, Aarhus BSS Business and Social Sciences, Aarhus University, Aarhus, Denmark; Department of Pediatric Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany; Corresponding author. Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, United Kingdom.Summary: Background: Avoidant restrictive food intake disorder (ARFID) is a new eating disorder with a heterogeneous clinical presentation. It is unclear which patient characteristics contribute to its heterogeneity. Methods: To identify these patient characteristics, we performed symptom-level correlation and driver-level regression analyses in our cross-sectional study in up to 261 ARFID patients (51% female; median age = 12.7 years) who were assessed at the Maudsley Centre for Child and Adolescent Eating Disorders, London between November 2019 and July 2022. Findings: Symptoms across the three drivers 1) avoidance based on sensory characteristics of food; 2) apparent lack of interest in eating; and 3) concern about aversive consequences positively correlated with each other. Patients' anxiety traits showed the greatest positive correlations with symptoms of concern about aversive consequences of eating. Patient sex was not significantly associated with any of the three ARFID drivers. Patients with comorbid autism spectrum disorder (ASD; 28%) showed more food-related sensory sensitivities (RR = 1.26) and greater lack of interest in eating (RR = 1.18) than those of patients without ASD (49%). Interpretation: In our clinical sample, the ARFID drivers occurred together and did not show clinically meaningful differences between the sexes. ASD may accentuate food-related sensory sensitivities and lack of interest, but may not drive a completely different symptom presentation. ARFID is multi-faceted and heterogenous, requiring a comprehensive multidisciplinary assessment to sufficiently understand the drivers of the restrictive eating behaviour. Results need replication in larger samples with more statistical power. Funding: None.http://www.sciencedirect.com/science/article/pii/S258953702300367XHeterogeneityClinical presentationPanic disorderBiological sexEating disorderDriver |
| spellingShingle | Rosie Watts Tanith Archibald Pippa Hembry Maxine Howard Cate Kelly Rachel Loomes Laura Markham Harry Moss Alfonce Munuve Anca Oros Amy Siddall Charlotte Rhind Mohammed Uddin Zain Ahmad Rachel Bryant-Waugh Christopher Hübel The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traitsResearch in context EClinicalMedicine Heterogeneity Clinical presentation Panic disorder Biological sex Eating disorder Driver |
| title | The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traitsResearch in context |
| title_full | The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traitsResearch in context |
| title_fullStr | The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traitsResearch in context |
| title_full_unstemmed | The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traitsResearch in context |
| title_short | The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traitsResearch in context |
| title_sort | clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex autism spectrum disorder and anxiety traitsresearch in context |
| topic | Heterogeneity Clinical presentation Panic disorder Biological sex Eating disorder Driver |
| url | http://www.sciencedirect.com/science/article/pii/S258953702300367X |
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