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      Long‐term follow‐up study of low‐weight avoidant restrictive food intake disorder compared with childhood‐onset anorexia nervosa: Psychiatric and occupational outcome in 56 patients

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          Abstract

          Objective

          To compare long term outcome between childhood‐onset Anorexia Nervosa (AN) and low‐weight Avoidant/Restrictive Food Intake Disorder (ARFID) in regard to psychiatric diagnoses, social and occupational functioning.

          Method

          A consecutive series of 56 children originally treated for low‐weight restrictive eating disorder (ED) were followed up after a mean of 15.9 years. ARFID‐diagnoses were assigned retrospectively.

          Results

          Thirty‐seven patients originally had AN and 19 patients were diagnosed retrospectively with ARFID. At follow‐up, in the AN‐group 21.6% had a current ED, 24.3% had another psychiatric diagnosis, and 54.1% did not have any psychiatric diagnosis. In the ARFID‐group, 26.3% had a current ED, 26.3% had another psychiatric diagnosis, and 47.4% had no psychiatric diagnosis. In the ARFID‐group ED diagnoses at follow‐up were all ARFID, whereas the AN‐group showed heterogeneity. Morgan Russell Outcome Assessment Schedule indicated similar outcome in the AN‐ and ARFID‐group. Occupational functioning did not differ significantly between the AN‐ and ARFID‐group.

          Discussion

          The AN‐group showed high rate of ED at follow up. The ARFID‐group had a similar outcome to AN. In the ARFID‐group, all ED‐cases at follow up had ARFID, possibly indicating symptomatic stability. Low‐weight ARFID should be treated as seriously as childhood onset AN.

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          Most cited references13

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          SCL-90: an outpatient psychiatric rating scale--preliminary report.

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            Adolescent-onset anorexia nervosa: 18-year outcome.

            The long-term outcome of anorexia nervosa is insufficiently researched. To study prospectively the long-term outcome and prognostic factors in a representative sample of people with teenage-onset anorexia nervosa. Fifty-one people with anorexia nervosa, recruited by community screening and with a mean age at onset of 14 years were compared with 51 matched comparison individuals at a mean age of 32 years (18 years after disorder onset). All participants had been examined at ages 16 years, 21 years and 24 years. They were interviewed for Axis I psychiatric disorders and overall outcome (Morgan-Russell assessment schedule and the Global Assessment of Functioning). There were no deaths. Twelve per cent (n=6) had a persisting eating disorder, including three with anorexia nervosa. Thirty-nine per cent of the anorexia nervosa group met the criteria for at least one psychiatric disorder. The general outcome was poor in 12%. One in four did not have paid employment owing to psychiatric problems. Poor outcome was predicted by premorbid obsessive-compulsive personality disorder, age at onset of anorexia nervosa and autistic traits. The 18-year outcome of teenage-onset anorexia nervosa is favourable in respect of mortality and persisting eating disorder.
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              Eating disorder examination questionnaire and clinical impairment assessment questionnaire: general population and clinical norms for young adult women in Sweden.

              Optimal use of assessment instruments for the detection and diagnosis of eating disorders (ED) depends on the availability of normative data. The aim of this work was to, for the first time, collect norms for both the Eating Disorder Examination Questionnaire (EDE-Q) and the newly developed Clinical Impairment Assessment (CIA) Scale from a general population of young women in Sweden, as well as from a clinical population of ED patients in Sweden. Participants were composed of both a randomized sample from the general population of women aged 18-30 years (N = 760) as well as from a clinical population aged 18-66 years (N = 2383). Data for the clinical population was extracted from the Stepwise database. Mean scores, standard deviations and percentile ranks for the global for the EDE-Q (as well as its subscales) and the CIA are presented. Prevalence figures of key eating disorder behaviors are also reported. Comparisons are made between the results in the present study with other existing normative studies on the EDE-Q and the CIA. The present study contributes to improving the accuracy of the interpretation of scores of the widely used self-report measure of ED, the EDE-Q, and the CIA, both of which play important roles in for diagnosis, prevention and intervention of ED. Copyright © 2010 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                andre.lange@med.lu.se
                Journal
                Int J Eat Disord
                Int J Eat Disord
                10.1002/(ISSN)1098-108X
                EAT
                The International Journal of Eating Disorders
                John Wiley & Sons, Inc. (Hoboken, USA )
                0276-3478
                1098-108X
                11 February 2019
                April 2019
                : 52
                : 4 , Child and Adolescent Feeding and Eating Disorders and Avoidant/Restrictive Food Intake Disorder ( doiID: 10.1002/eat.v52.4 )
                : 435-438
                Affiliations
                [ 1 ] Psychiatry Skane, Child and Adolescent Psychiatry Eating Disorders Centre Lund Sweden
                [ 2 ] Division of Child and Adolescent Psychiatry, Department of Clinical Sciences Lund University Sweden
                Author notes
                [*] [* ] Correspondence

                C. R. André Lange, Psychiatry Skane, Child and Adolescent Psychiatry, Eating Disorders Centre, Lund, Sweden.

                Email: andre.lange@ 123456med.lu.se

                Author information
                https://orcid.org/0000-0001-5533-6554
                Article
                EAT23038
                10.1002/eat.23038
                6593655
                30741442
                7c6a4d1b-80b3-4e62-b9bd-499c97f2ab26
                © 2019 The Authors. International Journal of Eating Disorders published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 28 July 2018
                : 21 January 2019
                : 22 January 2019
                Page count
                Figures: 0, Tables: 2, Pages: 4, Words: 3324
                Funding
                Funded by: Lindhaga Foundation
                Categories
                Brief Report
                Brief Report
                Custom metadata
                2.0
                eat23038
                April 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.5 mode:remove_FC converted:26.06.2019

                Clinical Psychology & Psychiatry
                anorexia nervosa,avoidant/restrictive food intake disorder,course,feeding and eating disorders of childhood,follow‐up studies,restrictive eating

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