Analysis of feeding and eating disorders in 191 children according to psychiatric or gastroenterological recruitment: The PEDIAFED cohort study.

Autor: Bertrand V; Pediatric Unit, Le Havre Hospital, Le Havre Cedex, France.; INSERM U1073, UNIROUEN, Normandie University, Rouen, France., Tavolacci MP; INSERM U1073, UNIROUEN, Normandie University, Rouen, France.; CIC 1404, Rouen University Hospital, Rouen, France., Bargiacchi A; Child and Adolescent Psychiatry Department, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Paris, France., Leblanc V; Pediatric Digestive Diseases Unit, Robert Debré University Hospital, Paris, France., Déchelotte P; INSERM U1073, UNIROUEN, Normandie University, Rouen, France.; Department of Nutrition, Rouen University Hospital, Rouen, France., Stordeur C; Child and Adolescent Psychiatry Department, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Paris, France., Bellaïche M; Pediatric Digestive Diseases Unit, Robert Debré University Hospital, Paris, France.
Jazyk: angličtina
Zdroj: European eating disorders review : the journal of the Eating Disorders Association [Eur Eat Disord Rev] 2024 May; Vol. 32 (3), pp. 589-605. Date of Electronic Publication: 2024 Feb 02.
DOI: 10.1002/erv.3063
Abstrakt: Objective: The DSM-5 classification introduced new Feeding and Eating Disorders (FED) diagnostic categories, notably Avoidant and Restrictive Food Intake Disorder (ARFID), which, like other FED, can present psychiatric and gastrointestinal symptoms. However, paediatric clinical research that focuses on children below the age of 12 years remains scarce. The aim of this study was first to investigate the clinical features of FED in a cohort of children, second to compare them according to their recruitment (gastroenterology or psychiatry unit).
Method: This non-interventional retrospective cohort study analysed 191 patients in a French paediatric tertiary care centre (gastroenterology n = 100, psychiatry n = 91). The main outcome variables were clinical data (type of FED, BMI, nutritional support, chronic diseases, psychiatric comorbidities, sensory, sleep, language disorders, gastrointestinal complaints, adverse life events, family history). The outcome was defined by a Clinical Global Impression of Change-score.
Results: FED diagnoses were ARFID (n = 100), Unspecified FED (UFED, n = 57), anorexia nervosa (AN, n = 33) and one pica/rumination. Mean follow-up was 3.28 years (SD 1.91). ARFID was associated with selective and sensory disorders (p < 0.001); they had more anxiety disorders than patients with UFED (p < 0.001). Patients with UFED had more chewing difficulties, language disorder (p < 0.001), and more FED related to chronic disease (p < 0.05) than patients with ARFID and AN. Patients with AN were female, underweight, referred exclusively to the psychiatrist, and had more depression than patients with ARFID and UFED (p < 0.001). The gastroenterology cohort included more UFED, while the psychiatry cohort included more psychiatric comorbidities (p < 0.001). A worse clinical outcome was associated with ARFID, a younger age at onset (p < 0.001), selective/sensory disorders and nutritional support (p < 0.05).
Conclusion: ARFID and UFED children were diagnosed either by gastroenterologists or psychiatrists. Due to frequently associated somatic and psychiatric comorbidities, children with FED should benefit from a multidisciplinary assessment and care.
(© 2024 Eating Disorders Association and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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