Avoidant/restrictive food intake disorder: Psychopathological similarities and differences in comparison to anorexia nervosa and the general population. (11th December 2020)

• Record Type: Journal Article
• Authors: Cañas, Laura; Palma, Carol; Molano, Ana M.; Domene, Lola; Carulla‐Roig, Marta; Cecilia‐Costa, Raquel; Dolz, Montserrat; Serrano‐Troncoso, Eduardo
• Is Part Of: European eating disorders review. Volume 29:Number 2(2021)
• Page Start: 245
• Page End: 256
• Publication Date: 2020-12-11
• Subjects: ARFID -- anorexia nervosa -- psychopathology -- comorbidity -- depression -- anxiety; Eating disorders -- Periodicals; 616.8526
• DOI: 10.1002/erv.2815
• Languages: English
• ISSNs: 1072-4133

Abstract

Abstract: Introduction: Avoidant/restrictive food intake disorder (ARFID) categorises patients with selective and/or restrictive eating patterns in the absence of distorted cognition concerning weight, food, and body image. Objective: To examine the sociodemographic and clinical profile of patients with ARFID in comparison to those with anorexia nervosa (AN) and to a non‐clinical group (NCG). Method: A descriptive, observational, comparative study made up of three groups (ARFID, AN and NCG). Ninety‐nine children and adolescents were analyzed by means of a semi‐structured diagnostic interview and questionnaires on depression, anxiety, clinical fears and general psychopathology. Results: The ARFID group was significantly younger (10.8 vs. 14.1 years of age), with a greater proportion of males (60.6% vs. 6.1%), an earlier onset of illness (6.2 vs. 13.4 years of age), and a longer period of evolution of the illness (61.2 vs. 8.4 months) compared to the AN group. Clinically, patients with ARFID showed greater medical (42.4% vs. 12.1%) and psychiatric (81.8% vs. 33.3%) comorbidity—assessed with a semi‐structured diagnostic interview—greater clinical fear ( p < 0.005), more attention problems ( p < 0.005) and fewer symptoms of anxiety and depression ( p < 0.005)—measured with self‐report questionnaires. Conclusions: ARFID is a serious disorder with a significant impact on the physical and mental health of the pediatric population. Likewise, some of these physical and mental conditions may be a risk factor in developing ARFID. Attention problems and clinical fears in ARFID, and the greater presence of internalised symptoms in AN, were the main differences found in the psychopathological profiles. Highlights: The sociodemographic variables and clinical characteristics had a heterogeneous distribution between patients with ARFID and those with AN, making it clear that the two diagnostic entities are distinct. Patients with ARFID compared to those with AN form a clinically heterogeneous group characterised for three patterns of restriction: lack of interest in eating, avoidance due to the sensory characteristics of food, and fear of aversive consequences related to food. Patients with ARFID have a significant impact on the physical and emotional development, in some instances equal to or greater than those with AN.