DSM: Pica, Rumination disorder, Avoidant/Restrictive Food Intake Disorder

Question 1

Pica -> diagnostic criteria

Answer 1

Pica
Diagnostic criteria:
- A: Persistent eating of non-nutritive, non-food substances over a period of at least 1 month.
- B: The eating of non-nutritive, non-food substances is inappropriate to the developmental level of the individual.
- C: The eating behaviour is not part of a culturally supported or socially normative practice.
- D: If the eating behaviour occurs in the context of another mental disorder (e.g., intellectual developmental disorder [intellectual disability], autism spectrum disorder, schizophrenia) or medical condition (including pregnancy), it is sufficiently severe to warrant additional clinical attention.

There is a need to specify when in remission: after full criteria for pica were previously met, the criteria have not been met for a sustained period of time.

Question 2

Rumination disorder ->
Diagnostic criteria

Answer 2

• A: Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spit out.
• B: The repeated regurgitation is not attributable to an associated gastrointestinal or other medical condition.
• C: The eating disturbance does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restrictive food intake disorder.
• D: If the symptoms occur in the context of another mental disorder, they are sufficiently severe to warrant additional clinical attention.

There is a need to specify when in remission: after full criteria for rumination disorder were previously met, the criteria have not been met for a sustained period of time.

Question 3

Avoidant/ restrictive food intake disorder ->
Diagnostic criteria

Answer 3

A: An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) associated with one (or more) of the following:
- Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
- Significant nutritional deficiency.
- Dependence on enteral feeding or oral nutritional supplements.
- Marked interference with psychosocial functioning.
B: The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.
C: The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced.
D: The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.

There is a need to specify when in remission: after full criteria for avoidant/restrictive food intake disorder were previously met, the criteria have not been met for a sustained period of time.