Avoidant/restrictive food intake disorder: pediatric comorbidities




Francisca Gomes Neves, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
Dário Ferreira, Department of Mathematics and Center of Mathematics, University of Beira Interior, Covilhã, Portugal
Paula Cristina Correia, Faculty of Health Sciences, University of Beira Interior; Department of Psychiatry, Service of Child and Adolescent Psychiatry, Cova da Beira University Hospital Center. Covilhã, Portugal


Introduction and objectives: Avoidant/Restrictive Food Intake Disorder (ARFID) is a newly-recognized feeding and eating disorder diagnosis in the DSM-5 (2013) and ICD-11 (2019). This systematic review aims to gather knowledge on prevalent comorbidities in pediatric ARFID patients. Methods: Following PRISMA guidelines, a systematic literature review was conducted, focusing on comorbidities in ARFID-diagnosed participants with a mean age inferior or equal to 18 years old. Covering the period from 2013 to September 2023, a search across PubMed and B-On resulted in 20 selected studies from an initial pool of 161 articles. The risk of bias was assessed using the ROBINS-I tool. PROSPERO CRD42024503067. Results: Medical comorbidities were detailed in eight studies, revealing that 38% of the comorbidities observed were gastrointestinal symptoms, 25% neurological conditions, and 10% immune system complications. Psychiatric comorbidities were addressed in most of the studies, with 45% of observations displaying anxiety disorders, 33% neurodevelopmental disorders, and 15% mood disorders. Various other medical and psychiatric conditions were also identified. Discussion: This review underscores the association between ARFID and diverse comorbidities, including gastrointestinal, neurological, and psychiatric conditions. It highlights the disorder’s complexity and the increased medical risks, advocating for early, multidisciplinary interventions and greater awareness among educators and health professionals. The need for comprehensive treatment involving various medical specialists is emphasized, along with the importance of family involvement and further research to enhance understanding and treatment of ARFID.



Keywords: Avoidant restrictive food intake disorder. Comorbidity. Child. Adolescent.




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  • DOI: 10.24875/PJP.24000036

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