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肥胖患者中报告的 ADHD 症状的流行率及相关因素:关注心境和焦虑共病、饮食失调和气质特征。

Prevalence and Correlates of Self-Reported ADHD Symptoms in Bariatric Patients: Focus on Mood and Anxiety Comorbidity, Disordered Eating, and Temperamental Traits.

机构信息

Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.

Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

出版信息

Obes Surg. 2024 Sep;34(9):3335-3347. doi: 10.1007/s11695-024-07308-z. Epub 2024 Jul 25.

Abstract

PURPOSE

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. A positive association between ADHD and obesity has been observed, especially in adult samples. In this study, prevalence and correlates of self-reported symptoms indicative of a positive screening for ADHD were examined in patients seeking bariatric treatment.

MATERIAL AND METHODS

The study sample was composed of 260 adult patients with obesity referred for bariatric surgery to the Obesity Center of the Endocrinology Unit in Pisa University Hospital between January 2006 and November 2016 (BMI ≥ 30 kg/m; mean ± standard deviation = 46.27 ± 7.45 kg/m). ADHD symptoms were identified using ADHD Symptom Check-List-90-R Screening Scale. Night-eating, binge-eating/purging behaviors, and temperamental and character traits were assessed in a subsample of 95 patients.

RESULTS

Thirty participants had a positive screening for ADHD (11.5%, 95% CI = 7.9-16.1%). Patients with a positive screening showed significantly higher rates of anxiety disorders (40% vs. 16.5%, χ = 7.97, p = 0.005) panic disorder (40% vs. 14.3%, χ = 10.48, p = 0.001), and a higher severity of psychopathological symptoms and sleep disturbances than those without. In subsample analyses, ADHD symptoms severity was associated with more bulimic behaviors (r = 0.31-0.46), greater harm avoidance (r = 0.45-0.66), less self-directedness (r =  - 0.44-0.63), and cooperativeness (r =  - 0.26-0.42).

CONCLUSION

ADHD symptoms may be common in patients with obesity seeking bariatric treatment and are positively associated with disordered eating, internalizing features, and maladaptive character traits.

LEVEL OF EVIDENCE

V, cross sectional descriptive study.

摘要

目的

注意力缺陷多动障碍(ADHD)是一种神经发育障碍,其特征为注意力不集中、多动和冲动。ADHD 与肥胖之间存在正相关关系,尤其是在成年人群中。本研究旨在检查接受减重治疗的患者中,自我报告的 ADHD 阳性筛查症状的患病率及其相关因素。

材料和方法

研究样本由 260 名因肥胖而被转诊至比萨大学医院内分泌科肥胖中心接受减重手术的成年患者组成(BMI≥30kg/m2;平均±标准差=46.27±7.45kg/m2)。使用 ADHD 症状检查表-90-R 筛查量表来确定 ADHD 症状。在 95 名患者的亚组中评估了夜间进食、暴食/清泻行为以及气质和性格特征。

结果

30 名参与者的 ADHD 筛查呈阳性(11.5%,95%置信区间[CI]=7.9-16.1%)。筛查阳性的患者焦虑障碍发生率显著更高(40%比 16.5%,χ2=7.97,p=0.005),惊恐障碍发生率也更高(40%比 14.3%,χ2=10.48,p=0.001),且精神病理学症状和睡眠障碍更为严重。在亚组分析中,ADHD 症状严重程度与更多的暴食行为(r=0.31-0.46)、更大的回避倾向(r=0.45-0.66)、更少的自我定向(r=-0.44-0.63)和合作性(r=-0.26-0.42)相关。

结论

ADHD 症状在寻求减重治疗的肥胖患者中较为常见,与饮食失调、内化特征和适应不良的性格特征呈正相关。

证据等级

V,横断面描述性研究。

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