Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;55(10):1397-1403.
doi: 10.1002/eat.23777. Epub 2022 Jul 18.

Differential comorbidity profiles in avoidant/restrictive food intake disorder and anorexia nervosa: Does age play a role?

P Evelyna Kambanis  1   2   3 , Stephanie G Harshman  2   4 , Megan C Kuhnle  2   4 , Danielle L Kahn  2   4 , Melissa J Dreier  1   2 , Kristine Hauser  4 , Meghan Slattery  4 , Kendra R Becker  2   3 , Lauren Breithaupt  2   3 , Madhusmita Misra  3   5   6 , Nadia Micali  7   8   9   10 , Elizabeth A Lawson  4   11 , Kamryn T Eddy  2   3 , Jennifer J Thomas  2   3
Affiliations

Differential comorbidity profiles in avoidant/restrictive food intake disorder and anorexia nervosa: Does age play a role?

P Evelyna Kambanis et al. Int J Eat Disord. 2022 Oct.

Abstract

Objective: Research comparing psychiatric comorbidities between individuals with avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) is limited. ARFID often develops in childhood, whereas AN typically develops in adolescence or young adulthood. Understanding how age may impact differential psychological comorbidity profiles is important to inform etiological conceptualization, differential diagnosis, and treatment planning. We aimed to compare the lifetime frequency of psychiatric comorbidities and suicidality between females with ARFID (n = 51) and AN (n = 40), investigating the role of age as a covariate.

Method: We used structured interviews to assess the comparative frequency of psychiatric comorbidities/suicidality.

Results: When age was omitted from analyses, females with ARFID had a lower frequency of depressive disorders and suicidality compared to AN. Adjusting for age, only suicidality differed between groups.

Discussion: This is the first study to compare comorbidities in a similar number of individuals with ARFID and AN, and a structured clinical interview to confer ARFID and comorbidities, covarying for age, and the first to compare suicidality. Although suicidality is at least three times less common in ARFID than AN, observed differences in other psychiatric comorbidities may reflect ARFID's relatively younger age of presentation compared to AN.

Public significance: Our results highlight that, with the exception of suicidality, which was three times less common in ARFID than AN irrespective of age, observed differences in psychiatric comorbidities in clinical practice may reflect ARFID's younger age at clinical presentation compared to AN.

Keywords: anorexia nervosa; anxiety, obsessive-compulsive, and trauma-related disorders; avoidant/restrictive food intake disorder; depressive and bipolar-related disorders; feeding and eating disorders; neurodevelopmental, disruptive, and conduct disorders; psychiatric comorbidities; structured clinical interview; suicidality.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest/disclosures: Drs. Thomas, Becker, and Eddy receive royalties from Cambridge University Press for the sale of their books about avoidant/restrictive food intake disorder. Dr. Misra has consulted for Sanofi and Abbvie and served on the Scientific Advisory Board of Abbvie and Ipsen. Dr. Lawson served on the scientific advisory board and has a financial interest in OXT Therapeutics, a company developing oxytocin-based therapeutics for obesity and metabolic disease. Dr. Lawson’s interests were reviewed and are managed by MGH and Mass General Brigham (f/k/a/Partners Healthcare) in accordance with their conflict of interest policies. Dr. Breithaupt is a consultant for HealthiVibe, a division of CorEvitas.

References

    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th ed. (DSM-5). Arlington, VA: American Psychiatric Association.
    1. Aulinas A, Marengi DA, Galbiati F, Asanza E, Slattery M, Mancuso CJ, Wons O, Micali N, Bern E, Eddy KT, Thomas JJ, Misra M, Lawson EA (2020). Medical comorbidities and endocrine dysfunction in low-weight females with avoidant/restrictive food intake disorder compared to anorexia nervosa and healthy controls. International Journal of Eating Disorders, 53(4), 631–636. - PMC - PubMed
    1. Aulinas A, Plessow F, Pulumo RL, Asanza E, Mancuso CJ, Slattery M, Tolley C, Thomas JJ, Eddy KT, Miller KK, Klibanski A, Misra M, & Lawson EA (2019). Disrupted oxytocin-appetite signaling in females with anorexia nervosa. Journal of Clinical Endocrinology and Metabolism, 104(10), 4931–4940. - PMC - PubMed
    1. Beck AT, Steer RA, & Brown GK (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.
    1. Becker KR, Mancuso C, Dreier MJ, Asanza E, Breithaupt L, Slattery M, Plessow F, Micali N, Thomas JJ, Eddy KT, Misra M, & Lawson EA (2021). Ghrelin and PYY in low-weight females with avoidant/restrictive food intake disorder compared to anorexia nervosa and healthy controls. Psychoneuroendocrinology, 129, 105243. - PMC - PubMed

Publication types