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The International Journal of Eating... Apr 2019Avoidant/restrictive food intake disorder (ARFID), pica, and rumination disorder (RD) were added to the revised DSM-5 Feeding and Eating Disorders chapter in 2013. We...
Development of the Pica, ARFID, and Rumination Disorder Interview, a multi-informant, semi-structured interview of feeding disorders across the lifespan: A pilot study for ages 10-22.
OBJECTIVE
Avoidant/restrictive food intake disorder (ARFID), pica, and rumination disorder (RD) were added to the revised DSM-5 Feeding and Eating Disorders chapter in 2013. We developed a structured interview-the Pica, ARFID, and Rumination Disorder Interview (PARDI)-to assess the presence and severity of these diagnoses for evaluation and treatment planning in clinical and research settings. Here, we describe the development of the PARDI and provide a preliminary report on feasibility, acceptability, reliability, and validity in relation to ARFID.
METHOD
We created an initial item pool from existing measures of similar constructs and clinical experience. The PARDI includes items assessing the level of endorsement and overall severity of common ARFID features organized into profiles (i.e., sensory sensitivity, lack of interest in eating, and fear of aversive consequences) and algorithms for diagnosing ARFID, pica, and RD. We collected initial psychometric data from participants (10-22 years) with ARFID (n = 39), clinically significant avoidant/restrictive eating (n = 8), and healthy controls (n = 10).
RESULTS
On average, the PARDI took 39 min to complete and was acceptable to participants. All subscales achieved internal consistency greater ≥0.77, and inter-rater reliability for the ARFID diagnosis was moderate (κ = 0.75). Individuals with ARFID scored significantly higher than healthy controls on ARFID severity and ARFID profiles.
DISCUSSION
The PARDI appears acceptable to respondents and preliminary evidence of reliability and validity has been demonstrated in an initial sample. Larger-scale validation studies are currently underway. The PARDI is freely available to clinicians and researchers.
Topics: Adolescent; Adult; Child; Feeding and Eating Disorders of Childhood; Female; Humans; Interviews as Topic; Male; Pica; Pilot Projects; Reproducibility of Results; Young Adult
PubMed: 30312485
DOI: 10.1002/eat.22958 -
Forensic Science, Medicine, and... Sep 2018Although death from food is not an uncommon finding in forensic facilities worldwide, the range of underlying lethal mechanisms and associated conditions that should be... (Review)
Review
Although death from food is not an uncommon finding in forensic facilities worldwide, the range of underlying lethal mechanisms and associated conditions that should be sought at the time of autopsy is quite disparate. Deaths may occur from i) infectious agents including bacteria, viruses, protozoa, cestodes, nematodes and prions; ii) natural toxins including amanita toxins, tetrodotoxin, ciguatera and scombroid; iii) anaphylaxis; iv) poisoning; v) mechanical issues around airway and gut obstruction and/or perforation; and vi) miscellaneous causes. Food-related deaths are important in terms of global mortality, and thus autopsies need to be comprehensive with full ancillary testing. Medicolegal matters may involve issues concerning likely exposure to infectious agents, possible foods ingested, the declared content and possible components of food, the significance of toxicological analyses, and aspects of duty of care in cases of café coronary syndrome and gastroenteritis while in care.
Topics: Airway Obstruction; Anaphylaxis; Esophageal Perforation; Food; Food Hypersensitivity; Food Microbiology; Foodborne Diseases; Forensic Medicine; Humans; Mediastinal Diseases; Obesity; Pica; Prader-Willi Syndrome
PubMed: 28710688
DOI: 10.1007/s12024-017-9899-9 -
Pediatrics Feb 2021Pica, the repeated ingestion of nonfood items, can be life-threatening. Although case reports describe pica in children with autism spectrum disorder (ASD) or...
BACKGROUND AND OBJECTIVES
Pica, the repeated ingestion of nonfood items, can be life-threatening. Although case reports describe pica in children with autism spectrum disorder (ASD) or intellectual disability (ID), there has been little systematic study of pica prevalence. We assessed pica in children 30 to 68 months of age (median = 55.4 months) with and without ASD.
METHODS
Our sample from the Study to Explore Early Development, a multisite case-control study, included children with ASD ( = 1426), children with other developmental disabilities (DDs) ( = 1735), and general population-based controls (POPs) ( = 1578). We subdivided the ASD group according to whether children had ID and the DD group according to whether they had ID and/or some ASD characteristics. Standardized developmental assessments and/or questionnaires were used to define final study groups, subgroups, and pica. We examined pica prevalence in each group and compared ASD and DD groups and subgroups to the POP group using prevalence ratios adjusted for sociodemographic factors.
RESULTS
Compared with the prevalence of pica among POPs (3.5%), pica was higher in children with ASD (23.2%) and DD (8.4%), and in the following subgroups: ASD with ID (28.1%), ASD without ID (14.0%), DD with ID (9.7%), DD with ASD characteristics (12.0%), and DD with both ID and ASD characteristics (26.3%); however, pica prevalence was not elevated in children with DD with neither ID nor ASD characteristics (3.2%). Between-group differences remained after adjustment (adjusted prevalence ratio range 1.9-8.0, all <.05).
CONCLUSIONS
Pica may be common in young children with ASD, ASD characteristics, and ID. These findings inform the specialized health care needs of these children.
Topics: Adult; Autism Spectrum Disorder; Case-Control Studies; Child, Preschool; Developmental Disabilities; Female; Humans; Intellectual Disability; Male; Pica; Young Adult
PubMed: 33408069
DOI: 10.1542/peds.2020-0462 -
Australian Family Physician 2017Pica, the eating of non-foods, occurs particularly in children and pregnant women. It has been observed in communities all over the world. Pica is associated with iron...
BACKGROUND
Pica, the eating of non-foods, occurs particularly in children and pregnant women. It has been observed in communities all over the world. Pica is associated with iron deficiency and, in some environments, lead poisoning. This is the first time a study has assessed the prevalence of pica in Australia.
METHODS
The study assessed the prevalence of pica in an Australian rural community, using a questionnaire given to parents of 223 children aged 2-10 years attending the five general practice surgeries in the shire.
RESULTS
The prevalence of non-ice pica in the study group was 9.4%, and 3.6% of this group ate soil.
DISCUSSION
The presence of pica should alert the treating clinician to consider iron deficiency and, in the case of polluted environments, lead exposure.
Topics: Adult; Anemia, Iron-Deficiency; Australia; Child; Child, Preschool; Female; Humans; Male; Pica; Pregnancy; Prevalence; Rural Population; Soil; Surveys and Questionnaires
PubMed: 28376581
DOI: No ID Found -
Industrial Psychiatry Journal Oct 2021Geophagia, a form of pica, is often associated with iron and zinc deficiency. However, a number of environmental, cultural, and psychological factors are also...
Geophagia, a form of pica, is often associated with iron and zinc deficiency. However, a number of environmental, cultural, and psychological factors are also implicated. Pica in children is common with those having intellectual disability. In adults, it is most commonly associated with pregnancy. No specific screening tests for pica exist, but many nutritional and psychological complications can be avoided by accurate and timely diagnosis. Even when pica is diagnosed, no proven treatments exist. Two patients who reported to the psychiatry outpatient department with habit of eating nonnutritive substances for a prolonged period associated with apprehension and decreased appetite are reported. Both the patients were diagnosed with adult pica and were treated with selective serotonin-reuptake inhibitors and psychotherapy with considerable improvement.
PubMed: 34908699
DOI: 10.4103/0972-6748.328819 -
Psychiatry and Clinical Neurosciences Jan 2019
Topics: Adolescent; Humans; Male; Narcotics; Pica; Substance Withdrawal Syndrome; Tramadol
PubMed: 30367530
DOI: 10.1111/pcn.12789 -
European Neurology 2017MRI is the imaging modality of choice for diagnosing brain infarction. Because of few or atypical clinical symptoms and a relatively low sensitivity of CT scans, many... (Review)
Review
BACKGROUND
MRI is the imaging modality of choice for diagnosing brain infarction. Because of few or atypical clinical symptoms and a relatively low sensitivity of CT scans, many cerebellar infarctions may be detected only with MRI. With adequate recognition of cerebellar infarction on MRI and prompt initiation or optimisation of preventive therapeutic measures, more dramatic strokes may be avoided in selected cases.
SUMMARY
We first briefly review the clinical presentation of cerebellar infarctions, followed by a short refresher on cerebellar anatomy and pathophysiological mechanisms of cerebellar infarcts. Then, we review the arterial cerebellar perfusion territories recently made visible with territorial arterial spin labeling (ASL), followed by a discussion and illustration of the MRI appearance of cerebellar infarcts in different stages. Similar to large cerebellar infarcts, recent studies investigating volumetric MRI datasets have now shown that small cerebellar infarcts occur in typical spatial patterns, knowledge of which may help in the diagnosis of even the smallest of cerebellar infarcts on MRI. Key Messages: MRI is the modality of choice for diagnosing cerebellar infarction. The posterior inferior cerebellar artery (PICA)-territories can be visualised with super-selective territorial ASL MRI. The PICA supplies at least the medial part of the posterior cerebellar surface. Anterior inferior cerebellar artery-infarcts can be mistaken for lateral PICA-infarcts. Small infarcts typically affect the cortex and often present as incidental cavities. Subacute cerebellar infarcts may be missed on imaging due to a phenomenon called "fogging."
Topics: Aged; Cerebellum; Cerebral Infarction; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged
PubMed: 28095387
DOI: 10.1159/000455229