Valeria Zanna1, Michela Criscuolo2, Alberta Mereu3, Giulia Cinelli4,5, Chiara Marchetto2, Patrizio Pasqualetti6,7, Alberto Eugenio Tozzi4, Maria Chiara Castiglioni2, Ilenia Chianello2, Stefano Vicari8. 1. Department of Neuroscience, Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, I.R.C.C.S. Bambino Gesù Children's Hospital, Piazza Sant' Onofrio 4, 00165, Rome, Italy. valeria.zanna@opbg.ne. 2. Department of Neuroscience, Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, I.R.C.C.S. Bambino Gesù Children's Hospital, Piazza Sant' Onofrio 4, 00165, Rome, Italy. 3. Child and Adolescent Psychiatry, Center of Excellence in Neuroscience, Children's Hospital A. Meyer-University of Florence, Florence, Italy. 4. Predictive and Preventive Medicine Research Unit, I.R.C.C.S. Bambino Gesù Children's Hospital, Rome, Italy. 5. School of Specialization in Food Science, University of Rome Tor Vergata, Rome, Italy. 6. Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, Rome, Italy. 7. Language and Communication Across Modalities Laboratory (LaCAM), Institute of Cognitive Sciences and Technologies (ISTC-CNR), Rome, Italy. 8. Department of Neuroscience, Child Neuropsychiatry Unit, I.R.C.C.S. Bambino Gesù Children's Hospital, Rome, Italy.
Abstract
PURPOSE: DSM-5 describe three forms of restrictive and selective eating: Anorexia Nervosa-Restrictive (AN-R), Anorexia Nervosa-Atypical (AN-A), and Avoidant/Restrictive Food Intake Disorder (ARFID). While AN is widely studied, the psychopathological differences among these three diseases are not clear. The aim of this study was to (i) compare the clinical features of AN-R, AN-A, and ARFID, in a clinical sample recruited from a specialized EDs program within a tertiary care children's Hospital; (ii) identifying three specific symptom profiles, to better understand if restrictive ED share a common psychopathological basis. METHODS: Data were collected retrospectively. Psychometric assessment included: the Children's Depression Inventory (CDI), the Multidimensional Anxiety Scale for Children (MASC), the Child Behavior Checklist (CBCL), and the Eating Disorder Inventory-3 (EDI-3). RESULTS: A final sample of 346 children and adolescent patients were analyzed: AN-R was the most frequent subtype (55.8%), followed by ARFID (27.2%) and AN-A (17%). Patients with ARFID presented different features from AN-R and AN-A, characterized by lower weight and medical impairment, younger age at onset, and a frequent association with separation anxiety and ADHD symptoms. EDI-3 profiles showed specific different impairment for both AN groups compared to ARFID. However, no differences was detected for items: 'Interpersonal Insecurity', "Interoceptive Deficits", "Emotional Dysregulation", and "Maturity Fears". CONCLUSIONS: Different ED profiles was found for the three groups, but they share the same general psychopathological vulnerability, which could be at the core of EDs in adolescence. LEVEL OF EVIDENCE: III. Evidence obtained from case-control analytic studies.
PURPOSE: DSM-5 describe three forms of restrictive and selective eating: Anorexia Nervosa-Restrictive (AN-R), Anorexia Nervosa-Atypical (AN-A), and Avoidant/Restrictive Food Intake Disorder (ARFID). While AN is widely studied, the psychopathological differences among these three diseases are not clear. The aim of this study was to (i) compare the clinical features of AN-R, AN-A, and ARFID, in a clinical sample recruited from a specialized EDs program within a tertiary care children's Hospital; (ii) identifying three specific symptom profiles, to better understand if restrictive ED share a common psychopathological basis. METHODS: Data were collected retrospectively. Psychometric assessment included: the Children's Depression Inventory (CDI), the Multidimensional Anxiety Scale for Children (MASC), the Child Behavior Checklist (CBCL), and the Eating Disorder Inventory-3 (EDI-3). RESULTS: A final sample of 346 children and adolescent patients were analyzed: AN-R was the most frequent subtype (55.8%), followed by ARFID (27.2%) and AN-A (17%). Patients with ARFID presented different features from AN-R and AN-A, characterized by lower weight and medical impairment, younger age at onset, and a frequent association with separation anxiety and ADHD symptoms. EDI-3 profiles showed specific different impairment for both AN groups compared to ARFID. However, no differences was detected for items: 'Interpersonal Insecurity', "Interoceptive Deficits", "Emotional Dysregulation", and "Maturity Fears". CONCLUSIONS: Different ED profiles was found for the three groups, but they share the same general psychopathological vulnerability, which could be at the core of EDs in adolescence. LEVEL OF EVIDENCE: III. Evidence obtained from case-control analytic studies.
Authors: K Bühren; R Schwarte; F Fluck; N Timmesfeld; M Krei; K Egberts; E Pfeiffer; C Fleischhaker; C Wewetzer; B Herpertz-Dahlmann Journal: Eur Eat Disord Rev Date: 2013-09-12
Authors: Andrea K Garber; Jing Cheng; Erin C Accurso; Sally H Adams; Sara M Buckelew; Cynthia J Kapphahn; Anna Kreiter; Daniel Le Grange; Vanessa I Machen; Anna-Barbara Moscicki; Kristina Saffran; Allyson F Sy; Leslie Wilson; Neville H Golden Journal: Pediatrics Date: 2019-11-06 Impact factor: 7.124