Comparison of clinical presentation and management of children and adolescents with ARFID between paediatrics and child and adolescent psychiatry: a prospective surveillance study

ObjectiveTo compare the clinical presentations, management and outcomes of avoidant/restrictive food intake disorder (ARFID) across paediatric and child and adolescent (C&A) psychiatric settings.Study designProspective surveillance study.MethodsData were collected during a 13-month prospective s...

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Bibliographic Details
Published in:	Archives of disease in childhood p. archdischild-2024-327032
Main Authors:	Haidar, Ellaha, Sanchez-Cerezo, Javier, Neale, Josephine, Julius, Nikita, Lynn, Richard, Hudson, Lee D, Nicholls, Dasha
Format:	Journal Article
Language:	English
Published:	England BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 17-10-2024 BMJ Publishing Group LTD
Subjects:	Adolescent Health Adolescents Age Anorexia Anxiety Disorders Autism Autism Spectrum Disorders Body Composition Body mass index Child & adolescent psychiatry Child Psychiatry Children Children & youth Comorbidity Cutting Scores Demographics Dietary supplements Eating behavior Eating disorders Epidemiology Ethnicity Evidence Based Practice Fear Food Food intake Interdisciplinary Approach Mental Disorders Mental health Nutrition Nutritional status Obesity Original research Overweight Paediatrics Patients Pediatrics Psychiatric Services Psychiatrists Questionnaires Scientific Concepts Statistical Data Statistical Significance Surveillance Teenagers Test Anxiety United Kingdom > UK Child Psychiatry Adolescent Health Epidemiology Paediatrics Mental health
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Summary:	ObjectiveTo compare the clinical presentations, management and outcomes of avoidant/restrictive food intake disorder (ARFID) across paediatric and child and adolescent (C&A) psychiatric settings.Study designProspective surveillance study.MethodsData were collected during a 13-month prospective surveillance study of children and adolescents with ARFID in the UK and Republic of Ireland. Paediatricians reported cases via the British Paediatric Surveillance Unit and psychiatrists through the Child and Adolescent Psychiatry Surveillance System. A follow-up questionnaire was sent at 12 months after a case of ARFID was reported.Results319 cases were included, 189 from paediatricians and 130 from C&A psychiatrists. Patients presenting to paediatricians were younger (9.8 years vs 13.7 years), more often male (62.4% vs 43.1%), and had more chronic symptoms (80.4% vs 67.0%), selective eating (63.7% vs 46.6%) and comorbid autism (67.6% vs 50.0%) than to psychiatrists. Psychiatrists saw patients with more fear of aversive consequences from eating (13.1% vs 3.2%), weight loss (76.7% vs 65.0%) and comorbid anxiety (78.2% vs 47.4%). Patients presenting to paediatricians more often received medical monitoring (74.6% vs 53.1%), dietetic advice (83.1% vs 70.0%) and nutritional supplements (49.2% vs 30.0%). At follow-up, both cohorts improved in nutritional status. However, the psychiatric cohort improved more regarding disordered eating behaviours.ConclusionsThe presentation and management of ARFID differs across clinical settings. Findings suggest the need to develop clinical pathways for ARFID assessment and management across paediatrics and mental health. Our findings highlight the potential benefits of psychiatric input for some patients with ARFID.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0003-9888 1468-2044 1468-2044
DOI:	10.1136/archdischild-2024-327032