Avoidant restrictive food intake disorder – A new diagnostic category in DSM-V (analytical review)

Abstract

Background: Avoidant Restrictive Food Intake Disorder (ARFID) was included in DSM-V in 2013. The disorder begins mainly at the age of 8-13. It is comorbid with autism spectrum disorders, mental retardation, generalized anxiety disorder, causes weight loss, impaired growth, difficulties in social life and school attendance. The aim of the study: The review aims to summarize clinically relevant information about ARFID for timely diagnosis and therapy. Materials and methods: The focus has been on the literature since the introduction of ARFID (from 2012-2015) using the term "avoidant/restrictive eating disorder". The review included articles from Web of Science, Scopus, Pub Med. Results: The 3.2% of children aged 8-13 years satisfy the diagnostic criteria of ARFID. In children and adolescents undergoing inpatient treatment with eating disorders ARFID was detected from 7.2% to 22.5% of cases. Children and adolescents with ARFID differ in their socio-demographic and clinical characteristics from those who suffer from anoxia nervosa and bulimia nervosa. They have a lesser weight, a longer duration of the disease and a greater likelihood of concomitant somatic complications and mental disorders. The symptoms of ARFID are manifold: difficulties in digesting certain foods, refusing certain colors or textures of food, eating only very small portions, lack of appetite or fear of eating after a frightening attack of suffocation or vomiting. ARFID risk factors include a number of biological, psychological, and sociocultural issues. Conclusion: During treatment, it is required to take into account the patient’s mental status, combination of therapy with other methods, weight recovery, and nutrition management. It is important to involve parents in the therapeutic process. Further study of the avoiding restrictive food intake disorder associated with eating and its comorbidity with mental disorders is needed in order to develop optimal approaches to therapy.