ABSTRACT: Theoretical background: This paper reviews the most significant diagnostic systems for feeding disorders in infancy in the international scientific literature. We examined the contribution of specific proposals for classification. The limits of the diagnostic criteria of the DSM-IVTR appeared evident in its poor specificity, and inability to differentiate among different subtypes of feeding disorders in early childhood. On the other hand, different diagnostic subtypes were identified by clinicians and researchers. In more recent years, the revision of the Diagnostic Classification: 0-3 offered clinicians a more satisfactory systematic diagnosis tool, including specific types of disorders based on the clinical manifestations of their onset, course and severity. Objective: The aim of this paper is to highlight the changes in the definition of feeding disorders in infancy, and to point out that definitions by feeding disorders subtypes, using specific operational diagnostic criteria, is an important step to better understand the clinical course for every subtype and the risk factors involved. Methodology: Based on the limitations of the DSM-IVTR, it has here been described in detail the innovations proposed by the Diagnostic Classification: 0-3R, the new guidelines of the DSM-5 and clinical and empirical studies in the various subtypes of feeding disorders that may occur in early childhood. Critical discussion and conclusions: In the field of feeding disorders in infancy, the recent diagnostic perspectives offered by the CD:0-3R and the revisions of the forthcoming publication of the DSM-5 are promising in directing the research studies towards more systematic studies which may confirm the definition of relevant clinical frameworks, ascertaining their prevalence, incidence, and their clinical significance through epidemiological studies. Further studies will have to clarify more empirical and clinical variables of individual and relational risk in family systems, which may be involved in the clinical diagnostic subtypes. The clinical identification of specific types of feeding disorder, and research based on empirical evidence in this field is very useful to understand the factors involved in the aetiology, the clinical course, the choice of treatment and the assessment of their effectiveness.
Quadri clinici rilevanti dei disturbi alimentari dell’infanzia: nuove prospettive nella classificazione diagnostica e nella ricerca. Feeding disorders in early childhood: new perspectives for diagnostic classification and research.
LUCARELLI, LOREDANA;
2012-01-01
Abstract
ABSTRACT: Theoretical background: This paper reviews the most significant diagnostic systems for feeding disorders in infancy in the international scientific literature. We examined the contribution of specific proposals for classification. The limits of the diagnostic criteria of the DSM-IVTR appeared evident in its poor specificity, and inability to differentiate among different subtypes of feeding disorders in early childhood. On the other hand, different diagnostic subtypes were identified by clinicians and researchers. In more recent years, the revision of the Diagnostic Classification: 0-3 offered clinicians a more satisfactory systematic diagnosis tool, including specific types of disorders based on the clinical manifestations of their onset, course and severity. Objective: The aim of this paper is to highlight the changes in the definition of feeding disorders in infancy, and to point out that definitions by feeding disorders subtypes, using specific operational diagnostic criteria, is an important step to better understand the clinical course for every subtype and the risk factors involved. Methodology: Based on the limitations of the DSM-IVTR, it has here been described in detail the innovations proposed by the Diagnostic Classification: 0-3R, the new guidelines of the DSM-5 and clinical and empirical studies in the various subtypes of feeding disorders that may occur in early childhood. Critical discussion and conclusions: In the field of feeding disorders in infancy, the recent diagnostic perspectives offered by the CD:0-3R and the revisions of the forthcoming publication of the DSM-5 are promising in directing the research studies towards more systematic studies which may confirm the definition of relevant clinical frameworks, ascertaining their prevalence, incidence, and their clinical significance through epidemiological studies. Further studies will have to clarify more empirical and clinical variables of individual and relational risk in family systems, which may be involved in the clinical diagnostic subtypes. The clinical identification of specific types of feeding disorder, and research based on empirical evidence in this field is very useful to understand the factors involved in the aetiology, the clinical course, the choice of treatment and the assessment of their effectiveness.
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