Prospective 2-Year Course and Predictors of Outcome in Avoidant/Restrictive Food Intake Disorder - 29/01/25
Abstract |
Objective |
To evaluate the 2-year course and outcomes of full and subthreshold avoidant/restrictive food intake disorder (ARFID) in youth aged 9 to 23 years at baseline using a prospective longitudinal design to characterize the remission and persistence of ARFID, evaluate diagnostic crossover, and identify predictors of outcome. Greater severity in each ARFID profile—sensory sensitivity, fear of aversive consequences, and lack of interest—was hypothesized to predict greater likelihood of illness persistence, controlling for age, sex, body mass index percentile, ARFID treatment status, and baseline diagnosis.
Method |
Participants (N = 100; age range, 9-23 years; 49% female; 91% White) were followed over 2 years. The Pica, ARFID, and Rumination Disorder Interview was used across 3 time points (baseline, year 1, year 2) to measure the severity of each ARFID profile and evaluate illness persistence or remission, and the Eating Disorder Assessment for DSM-5 was used to evaluate diagnostic crossover.
Results |
Across the 2-year follow-up period, half the participants persisted with their original diagnosis, and 3% of participants experienced a diagnostic shift to anorexia nervosa. Greater severity in the sensory sensitivity and lack of interest profiles was associated with higher likelihood of ARFID persistence at year 1 only; greater severity in the fear of aversive consequences profile was associated with higher likelihood of ARFID remission at year 2 only.
Conclusion |
Findings underscore the distinctiveness of ARFID from other eating disorders and emphasize its persistence over 2 years. Results also highlight the predictive validity and prognostic value of the ARFID profiles (ie, sensory sensitivity, fear of aversive consequences, lack of interest).
Plain language summary |
In this longitudinal study, the authors examined the course and outcomes of avoidant/restrictive food intake disorder (ARFID) in a sample of 100 youth aged 9 to 23 years over the course of 2 years. Across the 2-year follow-up period, half the sample persisted with their original diagnosis, and 3% of participants developed anorexia nervosa. Results indicate that profiles of greater sensory sensitivity to food and lack of interest in food/eating were associated with higher likelihood of ARFID persistence at year 1 only, whereas greater severity in the fear of aversive consequences of eating was associated with higher likelihood of ARFID remission at year 2 only. These findings highlight the persistence of ARFID and suggest that outcomes may vary depending on an individual’s ARFID presentation.
Le texte complet de cet article est disponible en PDF.Key words : ARFID, avoidant/restrictive food intake disorder, feeding and eating disorders, longitudinal course, longitudinal study
Plan
| Drs. Micali, Lawson, and Thomas are co–senior authors of this work. |
|
| Research reported in this publication was supported by the National Institute of Mental Health (NIMH) of the National Institutes of Health (NIH) under the following grants: R01MH108595 awarded to Drs. Thomas, Lawson, and Micali; R01MH103402 awarded to Drs. Misra, Eddy, and Lawson; K23MH125143 awarded to Dr. Becker; K24MH120568 awarded to Dr. Lawson; and K24MH135189 awarded to Dr. Thomas. Research reported in this publication was also supported by the National Institute of Diabetes and Digestive and Kidney Diseases grant P30DK040561 awarded to Dr. Lawson. |
|
| The research was performed with permission from Mass General Brigham Institutional Review Board. |
|
| Consent has been provided for descriptions of specific patient information. |
|
| This study was presented as an abstract at the International Conference on Eating Disorders 2023 Annual Meeting; June 1-3, 2023; Washington, District of Columbia. This study was presented as an abstract at the International Conference on Eating Disorders 2024 Annual Meeting; March 14-16, 2024; New York, New York. |
|
| All data used in this study are publicly available through the NIMH National Data Archive (nda.nih.gov) and can be used in accordance with NIMH policies. |
|
| Dr. Tabri served as the statistical expert for this research. |
|
| Disclosure: Dr. Becker has received funding from the NIMH grant number K23MH125143 and the Hilda and Preston Davis Foundation. Dr. Becker also has received honoraria from the Academy of Eating Disorders for serving as the Scientific Co-Chair for the 2022 International Conference on Eating Disorders and the Rome Foundation for an academic speaking engagement. Dr. Breithaupt has served as a consultant for HealthiVibe, a division of CorEvitas. Dr. Bern has received honoraria from Abbott Labs for a presentation on Feeding Disorders in Children at the XXVIII Congress of the SEGHNP in Palma, Mallorca (June 16-18, 2022). Dr. Eddy has served as a consultant for Equip Health; has received royalties from Cambridge University Press and Oxford University Press; and has received honoraria from the NIH, Massachusetts General Hospital Psychiatry Academy, and Swinburne University of Technology/Body Image and Related Disorders Conference. Dr. Eddy has also received funding from the NIMH grant numbers R01MH116205 and R61MH129331. Dr. Misra has served as a key opinion leader for Lumos Pharma, has received study drug from Tonix Pharmaceuticals, and has received royalties from UpToDate and Medscape. Dr. Lawson has served on the scientific advisory board and had a financial interest in OXT Therapeutics, a company that developed oxytocin-based therapeutics for metabolic disease; has received research funding and study drug from Tonix Pharmaceuticals, a company developing oxytocin-based therapeutics; and has received royalties from UpToDate. Dr. Lawson is also an inventor on provisional patents for concept of using oxytocin-based therapeutics for bone health in autism and cognitive control in attention deficit-hyperactivity disorder. Dr. Lawson and/or family members have declared stock in the following health care–related companies: Alphabet Inc., Intuitive Surgical, and Thermo Fisher Scientific. Dr. Thomas has served as a consultant for Equip Health and has received royalties from Feeding Matters; Nova Scotia Provincial Eating Disorders Service; Universidad Aldolfo Albanez; Australia New Zealand Academy for Eating Disorders; Psychiatric Annals; American Academy of Allergy, Asthma, & Immunology; Bright and Quirky Child Summit; Children’s Hospital of Atlanta; NIH; Healthy Weight Research Network; Massachusetts General Hospital Psychiatry Academy, New Haven Residential Treatment Center; Italian Society of Pediatry and Associazione Italiana Disturbi dell’Alimentazione e del Peso; Center for Psychology and Emotion Regulation; Icelandic Eating Disorders Association; Ontario Community Outreach Program for Eating Disorders; University College London; Orygen/Centre for Youth Mental Health, University of Melbourne; National Health Service Lanarkshire; Sanford Eating Disorders and Weight Management; Children’s Mercy Kansas City; Center for Emotional Wellness; and Western New York Comprehensive Care Center for Eating Disorders. Dr. Thomas has also received funding from the NIMH grant numbers R01MH108595, R01MH128246, K24MH135189, and R61MH129331. Drs. Kambanis, Tabri, Freizinger, Shrier, and Micali and Mss. McPherson, Gydus, Kuhnle, Stern, and Asanza have reported no biomedical financial interests or potential conflicts of interest. |
Vol 64 - N° 2
P. 262-275 - février 2025 Retour au numéro
Article précédent
- Racial–Ethnic Discrimination and Early Adolescents’ Behavioral Problems: The Protective Role of Parental Warmth
- Jinjin Yan, Elizabeth Jelsma, Yijie Wang, Youchuan Zhang, Zhenqiang Zhao, Heining Cham, Margarita Alegria, Tiffany Yip
- Sleep Physiology and Neurocognition Among Adolescents With Attention-Deficit/Hyperactivity Disorder
- Jessica R. Lunsford-Avery, Mary A. Carskadon, Scott H. Kollins, Andrew D. Krystal
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?