Feeding and Eating Disorder and Risk of Subsequent Neurodevelopmental Disorders: A Population-Based Cohort Study

Abstract

Background: There are limited data concerning the long-term mental health of children with feeding and eating disorder (FED). We aimed to investigate whether children with FED are at greater risks of developing emotional/behavioral disorders with onset usually during childhood, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID).Methods: We conducted a population-based cohort study, including all singleton births in Denmark from January 1, 1995, to December 31, 2015. For each child diagnosed with FED, 10 age- and sex-matched controls who did not meet the criteria for FED were randomly selected from the general population. Associations were estimated with Cox regression modes adjusting for other perinatal and maternal factors, and sibling analyses were performed for controlling potential confounding by shared familial (genetic or environmental) factors.Results: Of the 1,256,989 individuals in the cohort, there were 1967 (53.4% girls) children diagnosed with FED. Children with FED had higher risks for clinically diagnosed emotional/behavioral disorders with onset usually in childhood (hazard ratio [HR], 2.78; 95% CI, 2.34–3.31), ADHD (HR, 1.74; 95% CI, 1.33–2.26), ASD (HR, 3.05; 95% CI, 2.36–3.94), and ID (HR, 6.38; 95% CI, 4.48–9.11), compared with matched controls. Girls with FED are at greater risks for emotional/behavioral disorders and ID, but not ADHD and ASD. Alike, in sibling analysis, increased rates are also observed for other neurodevelopmental disorders, but not for ADHD.Conclusion: Children with FED are associated with substantially increased risks of emotional/behavioral disorders, ADHD, ASD, and ID. This study highlights the importance of carefully monitoring neurodevelopmental disorders in children with FED.

Feeding Problems Including Avoidant Restrictive Food Intake Disorder in Young Children With Autism Spectrum Disorder in a Multiethnic Population

“…High rates of coexisting neurodevelopmental and medical conditions, including feeding disorders, in ASD has been highlighted since the 1980s (21,22), but particularly during the last decade (23)(24)(25)(26)(27)(28)(29). In 2010, Gillberg (30) launched the concept of Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE), with a view to highlighting the overlap of symptoms and coexisting neurodevelopmental disorders in early childhood.…”

Co-existing mental and somatic conditions in Swedish children with the avoidant restrictive food intake disorder phenotype

“…22 Another study found sex differences in NDC comorbidity with in children diagnosed with a feeding and eating disorder before age 3. 31 This study has several strengths. We investigated ARFID-related mental and somatic comorbidities in the largest reported sample of children and adolescents with the ARFID phenotype to date.…”

“…22 Another study found sex differences in NDC comorbidity with in children diagnosed with a feeding and eating disorder before age 3. 31…”

Adolescents With Eating Disorders in Pediatric Practice – The European Academy of Paediatrics Recommendations

“…A specific cause of ED has not been established, but potential etiology includes genetic predisposition, cognitive and emotional vulnerability, social and environmental factors, such as pressure of the dominant cultural patterns and weight stigma ( 18 ). Moreover, in the group of children with ED, there are increased risks of emotional or behavioral disorders, attention-deficit/hyperactivity disorder and autism spectrum disorders ( 19 , 20 ).…”