Presence and influence of attention deficit hyperactivity disorder symptoms in adults with an eating disorder

Abstract

Resumen Fundamento: La coexistencia de trastornos de la conducta alimentaria (TCA) y del trastorno por déficit de atención e hiperactividad (TDAH) es frecuente. El objetivo del estudio fue cuantificar la presencia de sintomatología TDAH en pacientes adultos con TCA y evaluar posibles correlaciones entre ambas sintomatologías. Material y métodos: Estudio transversal en pacientes con TCA. Se cumplimentaron los cuestionarios Eating Attitudes Test de 40 ítems (EAT-40), Eating Disorder Inventory 3ª edición (EDI-3) y la versión abreviada del Adult ADHD Self-Report Scale (ASRS v1.1). Aquellos pacientes con ≥12 puntos en ASRS v1.1 completaron el cuestionario Attention Déficit Hyperactivity Disorder Rating Scale 4ª edición (ADHD-RS IV). Resultados: El 42,6% de los 108 pacientes incluidos puntuaron ≥12 en el ASRS v1.1. Estos sujetos puntuaron más en bulimia y en algunas escalas de desajuste psicológico del EDI-3, y aquellos con conductas de atracón y/o purga puntuaron más en Trastornos psicobiológicos del EAT-40 y en Insatisfacción corporal y Riesgo de TCA del EDI-3. No hubo diferencias en ADHD-RS IV según fueran cuadros restrictivos puros (n=13) o compulsivo-purgativos (n=33). La sintomatología TDAH correlacionó más con la clínica alimentaria y con el desajuste psicológico general en los casos compulsivo-purgativos. Conclusiones: En población clínica con TCA son frecuentes los síntomas sugestivos de TDAH, más en cuadros con clínica compulsivo-purgativa pero no necesariamente más intensos. La correlación entre TDAH y TCA es mayor en cuadros compulsivo-purgativos. Los síntomas de TDAH conllevan mayor desajuste psicológico y mayor gravedad a nivel alimentario en los cuadros con sintomatología compulsivo-purgativa.

Attention deficit hyperactivity disorder and eating disorders: an overlooked comorbidity?

“…This may be the case in treatment of ADHD with stimulants, which can occasionally induce mood swings, mania and bipolar disorder 4 . That could explain some cases of extreme decreased appetite (and weight) in children with ADHD treated with stimulants that can resemble anorexia nervosa , but that does not seem to be the case in the paper we are commenting on 1 . Symptom overlap may generate the diagnosis of both disorders (probably not the case in ED and ADHD).…”

“…A recent cross-sectional study carried out at an outpatient Eating Disorders program in San Sebastian (Guipúzcoa, Spain), consisting of 108 adult patients diagnosed with Eating Disorders (ED), found a disproportionately elevated rate of Attention Deficit Hyperactivity disorder (ADHD) diagnosis when using the Adult ADHD Self-Report Scale (ASRS-v1.1) 1 . Ruiz Feliu from the Donostia-Amara Mental Health Center, in collaboration with colleagues from the University of Navarra Clinic, Hospital Universitario Donostia and Ansoain Mental Health Center, discovered high ASRS scores in 42.6% of the patients 1 , which is a rate about 17 times higher than the expected rate of ADHD diagnosis in the general adult population (2.5%) 2 . They also observed a higher correlation of ADHD and ED in binge-purge types of eating disorder, those most commonly associated with greater impulsivity.…”

“…Finally, the study by Ruiz Feliu et al 1 is highly relevant and is an example of an integrative approach across different levels and systems (academic and clinical activity, public and private centers, located in two different autonomous communities in Spain). Thus, more collaborative research is needed to benefit patients.…”

Cultural Perceptions on Attention Deficit Hyperactivity Disorder (過動症) in Taiwan

“…Indeed, these harmful yet often unfounded claims contribute to an underestimated risk factor in the lives of individuals with ADHD (Kaushik et al, 2016). A consensus belief found across the literature states that stigmatization directly causes harm to patients of ADHD by increasing resistance to seeking proper medical treatment (Rummans et al, 2022;Vaingankar et al, 2017), heightened psychological distress (Masuch et al, 2019;Hinshaw & Stier, 2007), eating disorders (Feliu et al, 2022), substance abuse (Rohner et al, 2023), as well as an increased risk for other adverse psychiatric disorders due to its comorbidity (Perumareddi & Majarwitz, 2023). Additionally, studies have demonstrated a correlation between experienced stigmatization and worsened treatment adherence, treatment e cacy, symptom aggravation, life satisfaction, and mental well-being (Mueller et al, 2012), culminating in a significantly lower quality of life for those a ected by ADHD.…”