Development of an inpatient protocol for adolescents with avoidant/restrictive food intake disorder: a case study.

Journal: Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent

Volume: 33

Issue: 1

Year of Publication: 

Affiliated Institutions:  Department of Adolescent Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.

Abstract summary 

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterised by a pattern of eating that leads to failure to meet appropriate nutritional and/or energy needs.In the absence of evidence-based inpatient guidelines for adolescents with ARFID, we set out to develop and pilot an inpatient protocol for adolescents with ARFID. Identification of the key differences between managing inpatients with ARFID and anorexia nervosa (AN) led to modification of an existing AN protocol with the goals of better meeting patient needs, enhancing alignment with outpatient care, and improving outcomes. A case report of an adolescent with ARFID who had three hospital admissions is presented to highlight these changes. Interviews with this patient and her family were undertaken, together with key staff, to explore the challenges of the AN protocol for this patient and the perceived benefits and any limitations of the ARFID protocol for this patient and others.The new ARFID protocol supports greater choice of meals, without the need for rest periods after meals and bathroom supervision. The similarities with the AN protocol reflect the need to promote timely weight gain through meal support, including a staged approach to nutritional supplementation. The protocol appears to have been well accepted by the patient and her family, as well as by staff, and continues to be used in cases of ARFID.Further evaluation would help identify how well this protocol meets the needs of different adolescents with ARFID.

Authors & Co-authors:  Pogos Whitelaw Burton Sawyer

Study Outcome 

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Statistics
Citations :  American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th edn. APA; 2013.
Authors :  4
Identifiers
Doi : 
SSN : 1719-8429
Study Population
Male,Female
Mesh Terms
Other Terms
avoidant restrictive food intake disorder;clinical protocol;eating disorder;malnutrition;refeeding
Study Design
Case Study,Case Study,Case Study,Case Study,Case Study,Case Study
Study Approach
Country of Study
Publication Country
Canada