School of Psychology, Faculty of Health, Deakin Child Study Centre, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
Murdoch Children's Research Institute, Parkville, Australia.
Eur Child Adolesc Psychiatry. 2019 Nov;28(11):1507-1516. doi: 10.1007/s00787-019-01314-8. Epub 2019 Mar 19.
Although attention-deficit/hyperactivity disorder (ADHD) is associated with eating disorders (EDs), it is unclear when ED risk emerges in children with ADHD. We compared differences in body dissatisfaction and weight control behaviour in children with/without ADHD aged 12-13 years concurrently, and when aged 8-9 and 10-11 years, to determine when risk emerges. We also examined differences by ADHD medication status at each age. This study uses waves 1-5 from the Longitudinal Study of Australian Children (n = 2323-2972). ADHD (7.7%) was defined at age 12-13 years by both parent- and teacher-reported SDQ Hyperactivity-Inattention scores > 90th percentile, parent-reported ADHD diagnosis and/or ADHD medication treatment. Children reported body dissatisfaction and weight control behaviour at 8-9, 10-11 and 12-13 years. Children with ADHD had greater odds of body dissatisfaction at ages 8-9 and 12-13 years. Comorbidities drove this relationship at 8-9 but not at 12-13 years [adjusted odds ratio (AOR): 1.6; 95 % CI 1.1-2.4; p = 0.01]. At 12-13 years, children with ADHD had greater odds of both trying to lose and gain weight, regardless of BMI status. Comorbidities drove the risk of trying to lose weight in ADHD but not of trying to gain weight (AOR 2.3; 95% CI 1.1-4.6; p = 0.03), which is likely accounted for by ADHD medication treatment. ADHD moderately increases body dissatisfaction risk in children aged 8-9 and 12-13 years. Clinicians should monitor this and weight control behaviour throughout mid-late childhood, particularly in children with comorbid conditions and those taking ADHD medication, to reduce the likelihood of later ED onset.
虽然注意力缺陷/多动障碍 (ADHD) 与饮食失调 (ED) 有关,但 ADHD 儿童的 ED 风险何时出现尚不清楚。我们比较了 12-13 岁时患有/不患有 ADHD 的儿童在身体不满和控制体重行为方面的差异,同时比较了 8-9 岁和 10-11 岁时的差异,以确定风险何时出现。我们还在每个年龄段检查了 ADHD 药物治疗状态的差异。本研究使用澳大利亚儿童纵向研究的第 1-5 波(n=2323-2972)。12-13 岁时通过父母和老师报告的 SDQ 多动-注意力不集中分数(>第 90 百分位数)、父母报告的 ADHD 诊断和/或 ADHD 药物治疗来定义 ADHD(7.7%)。儿童在 8-9、10-11 和 12-13 岁时报告身体不满和控制体重行为。患有 ADHD 的儿童在 8-9 岁和 12-13 岁时更有可能出现身体不满。合并症在 8-9 岁时推动了这种关系,但在 12-13 岁时没有 [调整后的优势比(AOR):1.6;95%置信区间 1.1-2.4;p=0.01]。在 12-13 岁时,无论 BMI 状态如何,患有 ADHD 的儿童更有可能尝试减肥和增重。合并症增加了 ADHD 尝试减肥的风险,但不能增加体重的风险(AOR 2.3;95%置信区间 1.1-4.6;p=0.03),这可能是由于 ADHD 药物治疗。ADHD 会适度增加 8-9 岁和 12-13 岁儿童的身体不满风险。临床医生应在整个中晚期儿童期监测这一点和控制体重行为,特别是在有合并症的儿童和服用 ADHD 药物的儿童中,以降低日后发生 ED 的可能性。