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

Abstract

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.

Highlights

• ARFID prevalence estimates vary widely across studies and are highest in specialist feeding clinics. The one incidence study to date suggests that new presentations to clinical care are relatively rare.

• ARFID has a high rate of psychiatric comorbidity especially with anxiety disorders.

• Further epidemiological studies, especially using national surveillance methodology, will help planning and resource allocation for this patient group.