PEDIATRIC, NUTRITIONAL, AND LIMITED PSYCHOSOCIAL INTERVENTION FOR AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER (ARFID) IN AN ITALIAN LONGITUDINAL STUDY FROM INFANCY TO 11 YEARS OF AGE.

Objectives: The objective of this presentation is to evaluate the evolution of malnutrition and long-term psychopathological risk factors in an Italian cohort of children diagnosed with the first subtype of ARFID. Following a transactional model, which recognizes the complex interplay between the individual characteristics of the mother and the child in the origin of developmental psychopathology, this clinical study explored longitudinally the children’s malnutrition, maternal psychopathology, and dysfunctional eating attitudes and the emotional/behavioral development of children from infancy to prepuberty. Methods: Loredana Lucarelli, PhD, will report data from toddlers and their mothers, who were evaluated at the children’s mean ages of 2, 5, 7, and 11 years and received some psychoeducation about the children’s lack of interest in eating or food but did not pursue any specific psychotherapeutic treatment for various reasons, such as lived in or moved to another city, premature termination of treatment, and so on. However, these children were followed closely by their pediatricians and were treated with nutritional supplements at the hospitals in Rome and in their community. They were periodically called back for follow-up appointments at the hospital. Results: This clinical study shows continuation of symptoms when untreated and highlights the importance of early diagnosis and specific treatment. A steady improvement in the severity of malnutrition over time emerged, yet 73 percent of children still had ongoing mild to moderate to severe malnutrition at 11 years of age. These children showed increasing emotional/behavioral problems, and their mothers’ psychopathological and dysfunctional eating symptoms also worsened over time. At 11 years of age, the girls’ emotional/ behavioral problems and their mothers’ psychopathology were more severe than that of the boys and their mothers. Conclusions: The developmental course of children who received limited psychosocial interventions for their apparent lack of interest in eating or food up to the sensitive period of prepuberty is characterized by an enduring risk of malnutrition and increasing psychopathological risk factors in both the children and their mothers. EA, LONG, PSP https://doi.org/10.1016/j.jaac.2019.07.487