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The study titled "Avoidant/restrictive food intake disorder prognosis and its relation with autism spectrum disorder in Japanese children" investigates clinical factors influencing outcomes in Japanese children and adolescents diagnosed with Avoidant/Restrictive Food Intake Disorder (ARFID), with a particular focus on the role of comorbid Autism Spectrum Disorder (ASD).(PubMed)
Key Findings
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Study Design: A retrospective analysis of 48 patients aged between 3 and 17 years who visited Okayama University Hospital from 2011 to 2022. Patients were categorized into "good" and "poor" prognosis groups based on their clinical outcomes.(PubMed)
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ASD Comorbidity: Comorbid ASD was significantly more prevalent in the poor prognosis group (60%) compared to the good prognosis group (21%). Notably, over half of the ARFID patients with comorbid ASD were initially undiagnosed.(PubMed)
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Prognostic Factors: Multivariate logistic regression identified older age at first visit and comorbid ASD as statistically significant factors associated with poor prognosis in ARFID patients. There were no significant differences in body mass index standard deviation scores or maximal weight loss between the two groups.(PubMed)
Clinical Implications
The findings underscore the importance of early evaluation of developmental characteristics in children with ARFID. Given the high prevalence of undiagnosed ASD among ARFID patients with poor outcomes, clinicians should consider comprehensive developmental assessments early in the treatment process. This approach may facilitate more tailored interventions and potentially improve prognoses.(PubMed)
For a more detailed exploration of the study, you can access the full article here: (Wiley Online Library).
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The prognostic factors for Avoidant/Restrictive Food Intake Disorder (ARFID) can vary based on individual and clinical characteristics. Based on current research—including the study from Pediatrics International (DOI: 10.1111/ped.70040)—key prognostic factors that may influence the course and outcome of ARFID include:
🔑 Key Prognostic Factors for ARFID
1. Comorbid Autism Spectrum Disorder (ASD)
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Strongest predictor of poor prognosis in the Japanese cohort study.
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ASD-related sensory sensitivities and rigidity may worsen ARFID symptoms.
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Many patients with ARFID and poor outcomes had previously undiagnosed ASD.
2. Age at First Visit
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Older age at first clinical visit was associated with a worse prognosis.
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Suggests earlier detection and intervention can improve outcomes.
3. Sex
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Some studies suggest male sex may be more associated with sensory-based ARFID, though its direct effect on prognosis remains mixed.
4. Subtypes of ARFID
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Sensory-based restriction or fear-based eating (e.g., choking, vomiting) may have different trajectories.
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Mixed subtypes may pose more complex treatment challenges.
5. Psychiatric Comorbidities
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Anxiety, OCD, depression, or ADHD often co-occur.
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The presence of multiple psychiatric comorbidities may predict slower recovery or need for longer treatment.
6. Parental Psychopathology or Feeding Style
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Anxious or overcontrolling feeding practices may contribute to poor progress.
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Lack of family support or high parental stress may delay recovery.
7. Medical Complications
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Severe malnutrition or gastrointestinal conditions (e.g., GERD, constipation) can worsen symptoms or hinder refeeding efforts.
8. Treatment Engagement
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Early and consistent involvement in multidisciplinary treatment (e.g., pediatrician, dietitian, psychologist) improves prognosis.
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Motivation to change and family participation are important success predictors.
📌 Clinical Implication
Early identification, particularly of neurodevelopmental traits (e.g., ASD), and a comprehensive treatment approach are essential for improving long-term outcomes in ARFID patients.
Would you like a visual summary (e.g., infographic or table) of these factors?
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CHITTA VRITTI
On Changing Your Character If you make
disciplined, caring choices, you are slowly engraving
certain tendencies into your mind. You are making it
more likely that you will desire the right things and
execute the right actions. If you make selfish, cruel, or
disorganized choices, then you are slowly turning this
core thing inside yourself into something that is
degraded, inconstant, or fragmented.
—David Brooks
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