Sudden Onset Disordered Eating Behaviors and Appetite Issues in a Local Clinical Cohort of Children With Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS).
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Abstract
Objective: Abrupt onset restrictive food intake can be a cardinal symptom of pediatric acute-onset neuropsychiatric syndrome (PANS). However, few reports detail eating restriction patterns and baseline eating behaviors in patients with PANS, which we aim to address. Additionally, we aim to compare PANS eating restriction with ARFID.
Methods: Retrospective chart review of 130 patients with PANS, aged 4-18 years, presenting for initial assessment at Stanford's PANS/Immune Behavioral Health (IBH) Clinic. Data were abstracted from electronic medical records (EMR) and parent/child questionnaires which included symptom ratings and psychometric scores. Baseline eating restriction and abrupt onset changes in eating associated with PANS flares were studied.
Results: Over half (56%) of the PANS patients developed abrupt-onset restricted food intake during flare prompting clinic entry. Of youth with restricted intake, 48% had selective eating, 41% had low appetite/interest in food, 37% feared aversive consequences (26% swallowing/choking/vomiting concerns, 16% feared contamination), and 4% overweight concerns. Youth with restricted intake had high levels of emotional lability and/or depression (96%), irritability, aggression, or oppositional behaviors (89%), behavioral/developmental regression (60%), cognitive impairment (69%), and sensory amplification (64%). Baseline eating restriction was noted in 16 (12%), with 9 altering eating behaviors during flare.
Conclusions: Eating restriction is common during PANS flares, reasons align with 3 main presentations of ARFID: Selective eating, low appetite/interest, and fear of aversive consequences. High levels of other neuropsychiatric symptoms are noted in youth with PANS and eating restriction during flares. Twelve percent of PANS patients have baseline eating restriction; over half of whom alter eating behaviors during the flare.
期刊介绍：
Articles featured in the journal describe state-of-the-art scientific research on theory, methodology, etiology, clinical practice, and policy related to eating disorders, as well as contributions that facilitate scholarly critique and discussion of science and practice in the field. Theoretical and empirical work on obesity or healthy eating falls within the journal’s scope inasmuch as it facilitates the advancement of efforts to describe and understand, prevent, or treat eating disorders. IJED welcomes submissions from all regions of the world and representing all levels of inquiry (including basic science, clinical trials, implementation research, and dissemination studies), and across a full range of scientific methods, disciplines, and approaches.
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