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Proposed eating disorder diagnosis linked to cognitive, mental health concerns
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Children and adolescents who meet criteria for a newly proposed diagnostic category for DSM-5, avoidant/restrictive food intake disorder, are clinically distinct from those with anorexia nervosa or bulimia nervosa, according to new research.
“Their growth and nutrition is significantly impaired, and they often have mental health concerns or cognitive disorders,” Martin M. Fisher, MD, FSAHM, of Cohen Children’s Medical Center in New York, and colleagues wrote.
The retrospective case-control study included all cases of children and adolescents aged 8 to 18 years who met diagnostic criteria for avoidant/restrictive food intake disorder at seven pediatric/adolescent eating disorders programs in the United States and Canada in 2010.
Researchers found that of the 719 patients with eating disorders, 98 met criteria for avoidant/restrictive food intake disorder, 98 with anorexia nervosa and 66 with bulimia nervosa.
Patients with criteria for avoidant/restrictive food intake disorder were younger than those with anorexia nervosa or bulimia nervosa (12.9 vs. 15.6 vs. 16.5 years) and were sick longer (30.5 vs. 14.5 vs. 23.5 months). Participants with avoidant/restrictive food intake disorder had a percent median BMI (86.5) in between those with anorexia nervosa (81) and bulimia nervosa (107.5).
Researchers also found that participants with avoidant/restrictive food intake disorder often had a medical disorder (55% vs. 10% vs. 11%). They also were more likely to have an anxiety disorder (58% vs. 36% vs. 32%) but less likely to have a mood disorder (19% vs. 31% vs. 58%).
Some participants with avoidant/restrictive food intake disorder also had autism spectrum disorder (5%), cognitive impairment (6%), food allergy (6%), choking (14%), swallowing difficulty (10%), sensory issues (20%) and secondary gain (7%).
For more information:
Fisher MM. Abstract #18. Presented at: Society for Adolescent Health and Medicine 2013; March 13-16, 2013; Atlanta.
Disclosure: The researchers report no relevant financial disclosures.