SHOULD PEDIATRICIANS INVESTIGATE THE SYMPTOMS OF OBSESSIVE-COMPULSIVE DISORDER IN CHILDREN WITH FEEDING DIFFICULTIES?

ABSTRACT Objective: To review current evidence on the relationship between obsessive-compulsive disorder and feeding difficulties. Methods: Review the Science Direct and PubMed databases between 2007 and 2017 in English, Portuguese and Spanish. The search terms, used in association, were “obsessive compulsive disorder” and “picky eating/feeding difficulty”. Cohort, case control and cross sectional studies were included that analyzed children, adolescents and/or adults of any sample size from any country in the world. Opinion articles were excluded. Results: Around 245 articles were selected, and only 4 were included in this review, according to previous criteria. Results from the studies essentially described that there is indeed a difference in “picky” behaviors between subjects with and without obsessive-compulsive disorder. Patients with obsessive-compulsive disorder tend to have exacerbated symptoms of disgust, anxiety and a higher eating behavior inflexibility score. Conclusions: Obsessive-compulsive disorder and feeding difficulties patients share common symptoms. The present study alerts health professionals who follow patients with feeding difficulties as to the importance of investigating possible psychiatric comorbidities.

摘要
研究目的：梳理当前关于强迫症（obsessive-compulsive disorder）与进食困难之间关联的现有证据。
研究方法：于2007年至2017年间检索Science Direct及PubMed数据库，检索语言涵盖英语、葡萄牙语与西班牙语。采用联合检索策略，检索词为"obsessive compulsive disorder"与"picky eating/feeding difficulty"。纳入针对全球任意国家的儿童、青少年及成人开展的队列研究（cohort study）、病例对照研究（case-control study）及横断面研究（cross-sectional study），样本量不限；排除观点性文章。
研究结果：依据前述纳入标准，初步筛选得到约245篇文献，最终仅纳入4篇开展本综述分析。现有研究结果基本证实，强迫症患者与非强迫症群体在"挑食"行为层面确实存在差异。强迫症患者往往表现出更为显著的厌恶、焦虑症状，且进食行为灵活性评分更高。
研究结论：强迫症与进食困难患者存在共通的临床症状。本研究提醒接诊进食困难患者的医疗从业者，需重视对该类人群潜在精神共病的筛查工作。