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The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study

BACKGROUND: Restrictive eating problems are rare in children but overrepresented in those with neurodevelopmental problems. Comorbidities decrease wellbeing in affected individuals but research in the area is relatively scarce. This study describes phenotypes, regarding psychiatric and gastrointesti...

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Autores principales: Täljemark, Jakob, Råstam, Maria, Lichtenstein, Paul, Anckarsäter, Henrik, Kerekes, Nóra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563893/
https://www.ncbi.nlm.nih.gov/pubmed/28835820
http://dx.doi.org/10.1186/s40337-017-0154-2
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author Täljemark, Jakob
Råstam, Maria
Lichtenstein, Paul
Anckarsäter, Henrik
Kerekes, Nóra
author_facet Täljemark, Jakob
Råstam, Maria
Lichtenstein, Paul
Anckarsäter, Henrik
Kerekes, Nóra
author_sort Täljemark, Jakob
collection PubMed
description BACKGROUND: Restrictive eating problems are rare in children but overrepresented in those with neurodevelopmental problems. Comorbidities decrease wellbeing in affected individuals but research in the area is relatively scarce. This study describes phenotypes, regarding psychiatric and gastrointestinal comorbidities, in children with restrictive eating problems. METHODS: A parental telephone interview was conducted in 9- or 12-year old twins (n = 19,130) in the Child and Adolescent Twin Study in Sweden. Cases of restrictive eating problems and comorbid problems were established using the Autism, Tics-AD/HD and other Comorbidities inventory, parental reports of comorbidity as well as data from a national patient register. In restrictive eating problem cases, presence of psychiatric and gastrointestinal comorbidity was mapped individually in probands and their co-twin. Two-tailed Mann–Whitney U tests were used to test differences in the mean number of coexisting disorders between boys and girls. Odds ratios were used to compare prevalence figures between individuals with or without restrictive eating problems, and Fisher exact test was used to establish significance. RESULTS: Prevalence of restrictive eating problems was 0.6% (concordant in 15% monozygotic and 3% of dizygotic twins). The presence of restrictive eating problems drastically increased odds of all psychiatric problems, especially autism spectrum disorder in both sexes (odds ratio = 11.9 in boys, odds ratio = 10.1 in girls), obsessive-compulsive disorder in boys (odds ratio = 11.6) and oppositional defiant disorder in girls (odds ratio = 9.22). Comorbid gastrointestinal problems, such as lactose intolerance (odds ratio = 4.43) and constipation (odds ratio = 2.91), were the most frequent in girls. Boy co-twins to a proband with restrictive eating problems generally had more psychiatric problems than girl co-twins and more girl co-twins had neither somatic nor any psychiatric problems at all. CONCLUSIONS: In children with restrictive eating problems odds of all coexisting psychiatric problems and gastrointestinal problems are significantly increased. The study shows the importance of considering comorbidities in clinical assessment of children with restrictive eating problems.
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spelling pubmed-55638932017-08-23 The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study Täljemark, Jakob Råstam, Maria Lichtenstein, Paul Anckarsäter, Henrik Kerekes, Nóra J Eat Disord Research Article BACKGROUND: Restrictive eating problems are rare in children but overrepresented in those with neurodevelopmental problems. Comorbidities decrease wellbeing in affected individuals but research in the area is relatively scarce. This study describes phenotypes, regarding psychiatric and gastrointestinal comorbidities, in children with restrictive eating problems. METHODS: A parental telephone interview was conducted in 9- or 12-year old twins (n = 19,130) in the Child and Adolescent Twin Study in Sweden. Cases of restrictive eating problems and comorbid problems were established using the Autism, Tics-AD/HD and other Comorbidities inventory, parental reports of comorbidity as well as data from a national patient register. In restrictive eating problem cases, presence of psychiatric and gastrointestinal comorbidity was mapped individually in probands and their co-twin. Two-tailed Mann–Whitney U tests were used to test differences in the mean number of coexisting disorders between boys and girls. Odds ratios were used to compare prevalence figures between individuals with or without restrictive eating problems, and Fisher exact test was used to establish significance. RESULTS: Prevalence of restrictive eating problems was 0.6% (concordant in 15% monozygotic and 3% of dizygotic twins). The presence of restrictive eating problems drastically increased odds of all psychiatric problems, especially autism spectrum disorder in both sexes (odds ratio = 11.9 in boys, odds ratio = 10.1 in girls), obsessive-compulsive disorder in boys (odds ratio = 11.6) and oppositional defiant disorder in girls (odds ratio = 9.22). Comorbid gastrointestinal problems, such as lactose intolerance (odds ratio = 4.43) and constipation (odds ratio = 2.91), were the most frequent in girls. Boy co-twins to a proband with restrictive eating problems generally had more psychiatric problems than girl co-twins and more girl co-twins had neither somatic nor any psychiatric problems at all. CONCLUSIONS: In children with restrictive eating problems odds of all coexisting psychiatric problems and gastrointestinal problems are significantly increased. The study shows the importance of considering comorbidities in clinical assessment of children with restrictive eating problems. BioMed Central 2017-08-21 /pmc/articles/PMC5563893/ /pubmed/28835820 http://dx.doi.org/10.1186/s40337-017-0154-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Täljemark, Jakob
Råstam, Maria
Lichtenstein, Paul
Anckarsäter, Henrik
Kerekes, Nóra
The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study
title The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study
title_full The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study
title_fullStr The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study
title_full_unstemmed The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study
title_short The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study
title_sort coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide swedish twin study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563893/
https://www.ncbi.nlm.nih.gov/pubmed/28835820
http://dx.doi.org/10.1186/s40337-017-0154-2
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