儿童青少年回避性/限制性摄食障碍：评估与治疗

doi:10.12114/j.issn.1007-9572.2023.0422

摘要/Abstract

摘要： 进食障碍治疗成本高，且发病率逐年增高，与其他精神障碍相比，死亡风险也较高。回避性/限制性摄食障碍作为较新的一类进食障碍，相比其他年龄群体在儿童青少年群体中更易出现，影响儿童青少年正常生长发育和社会心理功能。目前，国外研究较多，国内研究尚处于起始阶段。因此，本文对儿童青少年回避性/限制性摄食障碍评估工具、影响因素和治疗方式进行综述，以期为国内开展相关研究提供借鉴。

关键词: 回避限制性摄食障碍, 评估工具, 影响因素, 治疗措施, 儿童青少年, 综述

Abstract:

Food intake disorders are costly to treat, with an increasing prevalence over the years, and a higher risk of mortality compared to other psychiatric disorders. Avoidant/restrictive food intake disorder (ARFID) , as a relatively new type of food intake disorder, is more prevalent in children and adolescents than in other age groups, affecting their normal growth and development, as well as psychosocial functioning. Currently, there are more foreign studies, while domestic studies are still in the initial stage. Therefore, this paper reviews assessment tools, influencing factors and treatment approaches for ARFID in children and adolescents, with the aim of providing a reference for related research in China.

Key words: Avoidant restrictive food intake disorder, Assessment tools, Influencing factors, Therapeutic measures, Children and adolescents, Review

王清玉,林征,雷阳,等. 儿童青少年回避性/限制性摄食障碍：评估与治疗[J]. 中国全科医学, 2024, 27(09): 1028-1033. DOI: 10.12114/j.issn.1007-9572.2023.0422.
WANG Qingyu,LIN Zheng,LEI Yang, et al. Assessment and Treatment of Avoidant/Restrictive Food Intake Disorder in Children and Adolescents[J]. Chinese General Practice, 2024, 27(09): 1028-1033. DOI: 10.12114/j.issn.1007-9572.2023.0422.

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评估工具	时间（年）	测评形式	适用人群	Cronbach's α系数	汉化版	优点	缺点
青少年饮食紊乱调查问卷（EDY-Q）^[9]	2013	自陈量表	≥14岁	0.62	无	①简单快捷 ②可以区分其他进食障碍	①信度较低
九项回避性/限制性摄食障碍筛查量表（NIAS）^[13]	2017	自陈量表	≥12岁	多样本检验为0.79~0.90	有	①简单快捷 ②信效度较好	①需结合其他量表进行区分 ②不适合胃肠道疾病患者筛查
回避性/限制性摄食障碍父母报告版问卷（ARFID-Q-PR）^[18]	2022	他评量表	2~10岁儿童	0.84	无	①可以区分其他进食障碍 ②信效度较好	①有待在多样本人群推广验证
异食癖、回避性/限制性摄食障碍和反刍障碍访谈（PARDI）^[19]	2019	半结构化访谈	全年龄段使用	评估ARFID分量表各维度为0.83~0.93	无	①可用于诊断 ②信效度较好	①需要心理医生指导使用 ②大规模筛查人力成本较高

评估工具	时间（年）	测评形式	适用人群	Cronbach's α系数	汉化版	优点	缺点
青少年饮食紊乱调查问卷（EDY-Q）^[9]	2013	自陈量表	≥14岁	0.62	无	①简单快捷 ②可以区分其他进食障碍	①信度较低
九项回避性/限制性摄食障碍筛查量表（NIAS）^[13]	2017	自陈量表	≥12岁	多样本检验为0.79~0.90	有	①简单快捷 ②信效度较好	①需结合其他量表进行区分 ②不适合胃肠道疾病患者筛查
回避性/限制性摄食障碍父母报告版问卷（ARFID-Q-PR）^[18]	2022	他评量表	2~10岁儿童	0.84	无	①可以区分其他进食障碍 ②信效度较好	①有待在多样本人群推广验证
异食癖、回避性/限制性摄食障碍和反刍障碍访谈（PARDI）^[19]	2019	半结构化访谈	全年龄段使用	评估ARFID分量表各维度为0.83~0.93	无	①可用于诊断 ②信效度较好	①需要心理医生指导使用 ②大规模筛查人力成本较高