Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment

Altfas, Jules R

doi:10.1186/1471-244x-2-9

Cited by 181 publications

(174 citation statements)

References 38 publications

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“…7 However, preliminary evidence surprisingly suggests a potential relationship between ADHD and obesity in clinical samples of obese adults and children seeking treatment. In a group of 215 adult patients treated for obesity, Altfas 8 found that 27.4% had ADHD (diagnosed according to DSM-IV criteria) and 33.5% presented with 'subthreshold' ADHD symptoms (i.e. symptoms of inattention and hyperactivity/impulsivity not meeting DSM-IV diagnostic criteria of ADHD).…”

Section: Introductionmentioning

confidence: 99%

Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents

et al. 2006

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Objective: Preliminary evidence suggests a comorbidity between attention-deficit/hyperactivity disorder (ADHD) and obesity. This study was carried out to identify the clinical characteristics of obese adolescents with a higher probability of ADHD and advance the understanding of the potential factors underlying the comorbidity between obesity and ADHD. We evaluated the association between ADHD symptoms and bulimic behaviors, depressive and anxiety symptoms, degree of obesity, pubertal stage, age and gender in a clinical sample of obese adolescents. Design: Cross-sectional study. Subjects: Ninety-nine severely obese adolescents aged 12-17 years. Measurements: Subjects filled out the Bulimic Investigatory Test, Edinburgh, the Beck Depression Inventory and the State-Trait Anxiety Inventory for Children. Their parents completed the Conners Parent Rating Scale, which assesses ADHD symptoms. The degree of overweight was expressed as body mass index-z score. Puberty development was clinically assessed on the basis of Tanner stages. Results: Bulimic behaviors were significantly associated with ADHD symptoms after controlling for depressive and anxiety symptoms. The degree of overweight, pubertal stage, age and gender were not significantly associated with ADHD symptoms. Conclusion: Obese adolescents with bulimic behaviors may have a higher probability to present with ADHD symptoms independently from associated depressive or anxiety symptoms. The degree of overweight, pubertal stage, age and gender might not be useful for detecting obese adolescents with ADHD symptoms. Therefore, we suggest systematic screening for ADHD in obese adolescents with bulimic behaviors. Further studies are needed to understand which specific dimension of ADHD primarily accounts for the association with bulimic behaviors. Future research should also investigate the causal link between bulimic behaviors and ADHD and explore potential common neurobiological alterations. This may lead to a better understanding of the effectiveness of stimulants for the treatment of bulimic behaviors in obese subjects.

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Section: Introductionmentioning

confidence: 99%

Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents

et al. 2006

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“…Specifically, when compared with normal weight individuals, obese subjects make less advantageous choices, which is a finding consistent with impaired inhibitory control and with prefrontal dysfunction (Pignatti et al, 2006). Moreover rates of attention deficit hyperactivity disorder (ADHD), which involves disruption in impulsivity, are elevated in obese individuals (Altfas, 2002). Similarly impulsivity has been linked with high BMI in some populations (Fassino et al, 2003) and in healthy controls BMI has also been associated with performance in tasks of executive function that mediate impulsivity (Gunstad et al, 2007).…”

Section: Study Limitationsmentioning

confidence: 84%

Low dopamine striatal D2 receptors are associated with prefrontal metabolism in obese subjects: Possible contributing factors

et al. 2008

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Dopamine's role in inhibitory control is well recognized and its disruption may contribute to behavioral disorders of discontrol such as obesity. However, the mechanism by which impaired dopamine neurotransmission interferes with inhibitory control is poorly understood. We had previously documented a reduction in dopamine D2 receptors in morbidly obese subjects. To assess if the reductions in dopamine D2 receptors were associated with activity in prefrontal brain regions implicated in inhibitory control we assessed the relationship between dopamine D2 receptor availability in striatum with brain glucose metabolism (marker of brain function) in ten morbidly obese subjects (BMI>40 kg/m 2 ) and compared it to that in twelve non-obese controls. PET was used with [ 11 C]raclopride to assess D2 receptors and with [ 18 F] FDG to assess regional brain glucose metabolism. In obese subjects striatal D2 receptor availability was lower than controls and was positively correlated with metabolism in dorsolateral prefrontal, medial orbitofrontal, anterior cingulate gyrus and somatosensory cortices. In controls correlations with prefrontal metabolism were not significant but comparisons with those in obese subjects were not significant, which does not permit to ascribe the associations as unique to obesity. The associations between striatal D2 receptors and prefrontal metabolism in obese subjects suggest that decreases in striatal D2 receptors could contribute to overeating via their modulation of striatal prefrontal pathways, which participate in inhibitory control and salience attribution. The association between striatal D2 receptors and metabolism in somatosensory cortices (regions that process palatability) could underlie one of the mechanisms through which dopamine regulates the reinforcing properties of food. KeywordsOrbitofrontal cortex; Cingulate gyrus; Dorsolateral prefrontal; Dopamine transporters; Raclopride, PET The increase in obesity and associated metabolic diseases seen over the past decade has raised concern that if not controlled this may become the number one preventable public health threat for the 21st century (Sturm, 2002 (Berthoud, 2007). The extent to which individuals differ in their ability to inhibit these responses and control how much they eat is likely to modulate their risk for overeating in our current food rich environments (Berthoud, 2007).We had shown that in healthy individuals D2 receptor availability in the striatum modulated eating behavioral patterns (Volkow et al., 2003). Specifically the tendency to eat when exposed to negative emotions was negatively correlated with D2 receptor availability (the lower the D2 receptors the higher the likelihood that an individual would eat if emotionally stressed). In addition, in a different study, we showed that morbidly obese subjects (BMI>40) had lower than normal D2 receptor availability and these reductions were proportional to their BMI (Wang et al., 2001). These findings led us to postulate that low D2 receptor availability could put an...

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“…Type 2 DM is characterized by insulin resistance on target tissues such as the brain. Altfas (34) reported that ADHD was highly prevalent among obese patients and highest in those with extreme obesity. Bruehl et al (35) reported that adolescents with type 2 DM with insulin resistance have significantly reduced hippocampal and prefrontal volumes and higher rates of global cerebral atrophy as compared with obese controls without insulin resistance.…”

Section: Discussionmentioning

confidence: 99%

Association of attention-deficit/hyperactivity disorder with diabetes: a population-based study

et al. 2013

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Background: cognitive impairment has been documented in adult diabetes but is unclear in pediatric diabetes. No study had been conducted to explore the relationship between attention-deficit/hyperactivity disorder (aDhD) and diabetes. Using a population-based data set, we aimed to examine the association between aDhD and a prior diagnosis of diabetes mellitus (DM) in Taiwan. Methods: a total of 4,302 patients with aDhD were selected as cases and 21,510 randomly selected subjects as controls. We used conditional logistic regression to calculate the odds ratio (OR) for having previously received a diagnosis of DM between subjects with and without aDhD. results: In this study, 116 of the 25,812 sampled subjects (0.5%) had received a diagnosis of DM prior to their index date. subjects with aDhD had a higher proportion of prior DM diagnoses than controls (0.9% vs. 0.4%, P < 0.001). after adjusting for age, sex, index year, geographic location, and obesity, aDhD was significantly associated with a prior diagnosis of type 2 DM (OR = 2.75, 95% confidence interval (cI) = 1.82-4.16). however, no significant association was observed between aDhD and type 1 DM. conclusion: The findings suggest that aDhD was associated with a previous diagnosis of type 2 DM.

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Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment

Cited by 181 publications

References 38 publications

Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents

Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents

Low dopamine striatal D2 receptors are associated with prefrontal metabolism in obese subjects: Possible contributing factors

Association of attention-deficit/hyperactivity disorder with diabetes: a population-based study

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