{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T10:22:41Z","timestamp":1781173361974,"version":"3.54.1"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T00:00:00Z","timestamp":1751155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1 R01 AR08138201A1"],"award-info":[{"award-number":["1 R01 AR08138201A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23 DK131334"],"award-info":[{"award-number":["K23 DK131334"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Patients with systemic sclerosis (SSc) may restrict food intake to manage their symptoms (particularly gastrointestinal [GI]). Whether some patients may develop nutritional and\/or quality\u2010of\u2010life impairments indicative of an eating disorder, avoidant or restrictive food intake disorder (ARFID), is unknown. We aimed to (1) identify the prevalence and characteristics of ARFID symptoms in patients with SSc and (2) explore the relationship among ARFID symptoms, GI symptom burden, and health\u2010related quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a cross\u2010sectional internet survey nationwide in Spain, patients with SSc completed the Spanish Nine\u2010Item ARFID Screen and assessments of gastrointestinal symptom burden (University of California Los Angeles Scleroderma Clinical Trial Consortium GI tract 2.0 [UCLA SCTC GIT 2.0]) and health\u2010related quality of life (12\u2010item Short Form Survey [SF\u201012]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 200 patients with SSc, 99 patients (49.5%) screened positive for ARFID. Just over half of those who screened positive for ARFID (n = 53) screened positive based on having a fear of aversive consequences around eating (eg, GI discomfort). A positive ARFID screen was associated with a greater frequency of self\u2010reported enteral nutrition, weight loss, and self\u2010initiated (vs provider\u2010monitored) diet restrictions. ARFID symptoms were moderately associated with worse GI symptom severity by UCLA GIT 2.0 total score (r = 0.408,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) but not for the reflux subscale (r = 0.058,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.420) and constipation subscale (r = 0.090,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.209) and with worse health\u2010related quality of life in all domains and both the physical and mental components of the SF\u201012 (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ARFID symptoms were relatively common in patients with SSc. Future research is needed to identify when a positive screen for ARFID reflects an adaptive response to disease or pathologic restriction indicative of ARFID warranting behavioral treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.25569","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T01:23:52Z","timestamp":1747099432000},"page":"1374-1383","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Avoidant or Restrictive Food Intake Disorder Symptoms in Adults With Systemic Sclerosis: A Nationwide Study in Spain"],"prefix":"10.1002","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3247-1539","authenticated-orcid":false,"given":"Luis G.","family":"Alcala\u2010Gonzalez","sequence":"first","affiliation":[{"name":"Digestive System Research Unit, Digestive Diseases Department Vall d'Hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Burton\u2010Murray","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micaela","family":"Atkins","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0626-507X","authenticated-orcid":false,"given":"Alfredo","family":"Guillen\u2010del\u2010Castillo","sequence":"additional","affiliation":[{"name":"Systemic Autoimmune Diseases Unit, Internal Medicine Department Vall d'Hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7097-1492","authenticated-orcid":false,"given":"Carolina","family":"Malagelada","sequence":"additional","affiliation":[{"name":"Digestive System Research Unit, Digestive Diseases Department, Vall d'Hebron University Hospital, Centro de Investigaci\u00f3n Biom\u00e9dica en Red Enfermedades Hep\u00e1ticas y Digestivas, and Department of Medicine Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3361-4909","authenticated-orcid":false,"given":"Michael","family":"Hughes","sequence":"additional","affiliation":[{"name":"Division of Musculoskeletal and Dermatological Sciences, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK, and Northern Care Alliance NHS Foundation Trust, Salford Care Organisation  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6461-8940","authenticated-orcid":false,"given":"Zsuzsanna H.","family":"McMahan","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3390-9029","authenticated-orcid":false,"given":"Carmen P.","family":"Sime\u00f3n\u2010Aznar","sequence":"additional","affiliation":[{"name":"Systemic Autoimmune Diseases Unit, Internal Medicine Department Vall d'Hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead486"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-023-00929-1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2021.101666"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25176"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-217035"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-222020"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keae394"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rap\/rkae037"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2018.12.001"},{"issue":"8","key":"e_1_2_7_11_1","first-page":"1606","article-title":"Scleroderma Patient\u2010centred Intervention Network (SPIN) Diet and Nutrition Education Patient Advisory Team, on behalf of the SPIN Investigators. 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