Who is treating ARFID, and how? The need for training for community clinicians

Magel, Chantelle Alice; Hewitt, Kim; Dimitropoulos, Gina; Ranson, Kristin M. von; McMorris, Carly A.

doi:10.1007/s40519-020-01007-1

Cited by 10 publications

(5 citation statements)

References 4 publications

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“…The latter may be of relevance for surveillance studies which rely on professionals reporting identified cases. It is widely acknowledged that current recognition of ARFID presentations and knowledge about the correct application of diagnostic criteria remains limited amongst health care practitioners, many of whom lack experience or confidence in distinguishing ARFID either from normative “picky eating” (Zickgraf, Lane‐Loney, et al., 2019 ), which can result in over‐identification, or other eating disorders (Coelho et al., 2021 ; Magel et al., 2021 ). It may not occur to practitioners to administer screening measures when symptoms of ARFID are observed but not recognised as such.…”

Section: Resultsmentioning

confidence: 99%

Current evidence for avoidant restrictive food intake disorder: Implications for clinical practice and future directions

Archibald

Bryant‐Waugh

2023

JCPP Advances

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Background: ARFID (avoidant restrictive food intake disorder) is a relatively new diagnostic term covering a number of well-recognised, clinically significant disturbances in eating behaviour unrelated to body weight/shape concerns. Its phenotypic heterogeneity combined with much about the condition remaining unknown, can contribute to uncertainties about best practice. While other reviews of the evidence base for ARFID exist, few specifically target health care professionals and implications for clinical practice.Methods: A narrative review was conducted to synthesise the findings of ARFID papers in scientific journals focussing on four key areas relevant to clinical practice: prevalence, assessment and characterisation of clinical presentations, treatment, and service delivery. Freely available online databases were searched for case studies and series, research reports, review articles, and meta-analyses. Findings were reviewed and practice implications considered, resulting in proposed clinical recommendations and future research directions. Results:We discuss what is currently known about the four key areas included in this review. Based on available evidence as well as gaps identified in the literature, recommendations for clinical practice are derived and practice-related research priorities are proposed for each of the four of the areas explored. Conclusion:Prevalence studies highlight the need for referral and care pathways to be embedded across a range of health care services. While research into ARFID is increasing, further studies across all areas of ARFID are required and there remains a pressing need for guidance on systematic assessment, evidence-based management, and optimal service delivery models. Informed clinical practice is currently predominantly reliant on expert consensus and small-scale studies, with ongoing routine clinical data capture, robust treatment trials and evaluation of clinical pathways all required. Despite this, a number a positive practice points emerge.

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Section: Resultsmentioning

confidence: 99%

Current evidence for avoidant restrictive food intake disorder: Implications for clinical practice and future directions

Archibald

Bryant‐Waugh

2023

JCPP Advances

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“…ARFID is still often unrecognised by health professionals. A small survey of clinicians in Canada reported that less than 50% of the participants had heard of ARFID previously (Magel et al., 2021 ). Similarly, a survey of Yogo teachers (responsible for monitoring students' height and weight and leading on health education), found that only 13% of the participants had encountered students with symptoms of ARFID (Seike et al., 2016b ).…”

Section: Discussionmentioning

confidence: 99%

What do we know about the epidemiology of avoidant/restrictive food intake disorder in children and adolescents? A systematic review of the literature

Sanchez-Cerezo

Nagularaj

Gledhill

et al. 2022

Euro Eating Disorders Rev

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Background: Avoidant/restrictive food intake disorder (ARFID) was a new diagnosis in DSM-5. This systematic review explores what is known to date about the epidemiology of ARFID in children and adolescents. Method: Embase, Medline and PsycInfo were used to identify studies meeting inclusion criteria. PRISMA guidelines were followed. Results: Thirty studies met inclusion criteria, with most coming from specialised eating disorder services where prevalence rates were 5%-22.5%. Three studies from specialist feeding clinics showed the highest prevalence rates, ranging from 32% to 64%. Studies from non-clinical samples reported ARFID prevalence estimates ranging from 0.3% to 15.5%. One study, using national surveillance methodology, reported the incidence of ARFID in children and adolescents reaching clinical care to be 2.02 per 100,000 patients. Psychiatric comorbidity was common, especially anxiety disorders (9.1%-72%) and autism spectrum disorder (8.2%-54.75%). Conclusion:The current literature on the epidemiology of ARFID in children and adolescents is limited. Studies are heterogeneous with regard to setting and sample characteristics, with a wide range of prevalence estimates. Further studies, especially using surveillance methodology, will help to better understand the nature of this disorder and estimate clinical service needs.

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“…Healthcare professionals report unfamiliarity with the ARFID diagnosis limiting their confidence in their clinical assessment of patients. 29 , 30 Our research contributes to our existing knowledge by describing the socio-demographic and clinical characteristics of children and adolescents with ARFID. Past research has been constrained by small sample sizes, non-standardised clinical assessment, and retrospective reviews of medical records.…”

Section: Introductionmentioning

confidence: 97%

The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traits

Watts,

Archibald,

Hembry

et al. 2023

eClinicalMedicine

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Who is treating ARFID, and how? The need for training for community clinicians

Cited by 10 publications

References 4 publications

Current evidence for avoidant restrictive food intake disorder: Implications for clinical practice and future directions

Current evidence for avoidant restrictive food intake disorder: Implications for clinical practice and future directions

What do we know about the epidemiology of avoidant/restrictive food intake disorder in children and adolescents? A systematic review of the literature

The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traits

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