Avoidant/restrictive food intake disorder (ARFID): systematic review of case studies / Trastorno de evitación/restricción de la ingesta de alimentos (TERIA): revisión sistemática de estudios de caso

Abstract Avoidant/restrictive food intake disorder (ARFID) has a complex clinical presentation. Since its recognition in the DSM-5, investigations have provided data of this condition, however, its treatment has mostly been reported in case studies. Therefore, the objective of the present study was analyzed clinical characteristics and clinical interventions reported in case reports and case series studies of ARFID, from a literature review according to the PRISMA and CARE guidelines. In total, 41 articles were examined, most of the reported cases were males (53.85%) with ages between 10 to 13 (29.23%), although, 15.38% of the cases had an age range of 20 to 56. Regarding their symptoms, the most frequent was underweight (66.15%), however, 3.08% of these patients were overweight linked to carbohydrate consumption. The most frequent psychiatric comorbidities were anxiety disorders (38.46%). Lastly, the most widely used was hospital treatment (46.34%), with a multidisciplinary approach (65.85%) and as for the most used psychological intervention was Cognitive Behavioral Therapy (21.95%).

Resumen El Trastorno de evitación/restricción de la ingesta de alimentos (TERIA) tiene una presentación clínica compleja. Desde su reconocimiento en el DSM-5 se han realizado investigaciones que aportan datos de esta condición, sin embargo, su tratamiento se ha reportado mayormente en estudios de casos. Por tanto, el objetivo del presente estudio fue analizar las características e intervenciones clínicas de estudios y series de casos del TERIA, a partir de una revisión de la literatura con base a los lineamientos PRISMA y CARE. En total se examinaron 41 artículos, la mayoría de los casos reportados fueron en hombres (53.85%) con edades entre 10 a 13 (29.23%), aunque, 15.38% de los casos tenían un rango de edad de 20 a 56 años. En cuanto a sus síntomas, el más frecuente fue el bajo peso (66.15%), sin embargo, 3.08% de estos pacientes presentaba sobrepeso ligado al consumo de carbohidratos. Las comorbilidades psiquiátricas más frecuentes fueron los trastornos de ansiedad (38.46%). Por último, el tratamiento más utilizado fue el hospitalario (46.34%), con abordaje multidisciplinar (65.85%) y en cuanto a la intervención psicológica más utilizada fue la Terapia Cognitivo Conductual (21.95%).

Construcción y validación del Cuestionario de Pica y Rumiación (CuPRu) en adolescentes y adultos jóvenes mexicanos / Construction and validation of the Pica and Rumination Questionnaire in Mexican adolescents and young adults

La investigación de los trastornos de Pica y Rumiación se ha centrado en niños, personas con discapacidad y mujeres embarazadas, lo anterior tieneimportantes implicaciones debido a que se desconoce si estos se presentan en otras etapas del desarrollo y en otras poblaciones. Su padecimientoconduce a importantes problemas en la salud e incluso pueden llegar a derivar en la muerte, por lo que es indispensable contar con instrumentosde tamizaje válidos y confiables. Por tanto, el objetivo de este estudio fue desarrollar un instrumento para detectar los síntomas y conductas detrastornos de Pica y Rumiación, así como determinar sus propiedades psicométricas. Los reactivos fueron elaborados a partir de la revisión de laliteratura y posteriormente fueron sometidos a revisión por siete expertos en el área, obteniendo coeficientes V de Aiken que indican un alto acuerdoentre jueces respecto al contenido del instrumento. Asimismo, se verificó su confiabilidad a partir de los coeficientes alfa 0.85 y omega 0.93. Posteriomente se llevó a cabo un Análisis Factorial Exploratorio y Confirmatorio, donde logró una estructura de cuatro factores que explican el 48.35%de la varianza, además los siguientes índices que corroboran un ajuste adecuado CMIN = 2.41, GFI = 0.92; AGFI = 0.89; CFI = 0.93; RMR=.063y RMSEA = 0.064. Por último, se realizó la calibración de los reactivos donde se observó que todos discriminaban adecuadamente. En conclusión,las propiedades psicométricas obtenidas en este estudio demuestran que el Cuestionario de Pica y Rumiación, es válido y confiable. (AU)

Research on Pica and RuminationDisorders has focused on children, people with disabilities, and pregnant women. This has important implications because it is unknown whetherthese occur at other stages of development and in other populations. These conditions leads to important health problems and can even lead todeath, so it is essential to have valid and reliable screening instruments. Therefore, the objective of this study was to develop an instrument to detectthe symptoms and behaviors of Pica and Rumination disorders, as well as to determine their psychometric properties in Mexican adolescents andyoung adults. The items were prepared from the review of the literature and were subsequently submitted for review by seven experts in the area,obtaining Aiken’s V coefficients that indicate a high agreement between judges regarding the content of the instrument. Likewise, the reliability ofthe scale was verified from the calculation of the alpha and omega coefficients, where the following indices were obtained: 0.85 and 0.93. Subsequently, an Exploratory and Confirmatory Factor Analysis was carried out, where a structure of four factors was achieved that explains 48.35% of thevariance, in addition to the following indices that corroborate an adequate fit CMIN = 2.41, GFI = 0.92; AGFI = 0.89; CFI = 0.93; RMR =.063 andRMSEA = 0.064. Finally, the calibration of the reagents was carried out where it was observed that all discriminated adequately. In conclusion, thepsychometric properties obtained in this study show that the Pica and Rumination Questionnaire is valid and reliable. (AU)

Cross-cultural adaptation and validation of the Nine Item ARFID Screen (NIAS) in Mexican youths.

Avoidant/Restrictive Food Intake Disorder (ARFID) is defined by limited volume or variety of food intake motivated by the sensory properties of food, fear of aversive consequences, or lack of interest in food or eating associated with medical, nutritional, and psychosocial impairment. Currently, two of the most widely validated measures are The Eating Disturbances in Youth-Questionnaire (EDY-Q) and the Nine Item ARFID Screen (NIAS). The latter has proven valid and reliable for assessing this disorder. OBJECTIVE: To validate a culturally sensitive adaptation of the NIAS instrument and evaluate its psychometric properties in Mexican youths. METHOD: The sample consisted of 800 participants aged 12-30 (M = 18.56, SD = 3.52) from Mexico City and Hidalgo public educational institutions. RESULTS: The S-NIAS obtained a Cronbach's alpha of 0.84, adequate construct validity adjustment rates: CMIN = 1.88; GFI = 0.97; AGFI = 0.94; CFI = 0.98; RMR = 0.050; and RMSEA = 0.047. Measurement invariance by gender, age, and survey administration which show that construct is understood in the same way across both groups and despite the change from paper-and-pencil to online survey administration. CONCLUSION: The psychometric properties of the Spanish Nine Item ARFID Screen (S-NIAS) indicate that it is a valid and reliable instrument for evaluating symptoms associated with ARFID in this sample of youths. PUBLIC SIGNIFICANCE: Although there are advances in studying ARFID, their epidemiological data comes mainly from a few countries. Furthermore, these data are scarcer due to the lack of validated screening and assessment instruments available in a variety of world languages; having instruments for the evaluation of ARFID symptoms is essential because it could function as an auxiliary means for the detection and prevention of people at risk.