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成人注意力缺陷多动障碍症状与暴饮暴食谱系疾病、精神和躯体共病以及医疗保健利用之间的关联。

Associations of adult ADHD symptoms with binge eating spectrum conditions, psychiatric and somatic comorbidity, and healthcare utilization.

作者信息

Appolinario Jose Carlos, de Moraes Carlos Eduardo F, Sichieri Rosely, Hay Phillipa, Faraone Stephen V, Mattos Paulo

机构信息

Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Translational Health Research Institute, School of Medicine, Western Sydney University, New South Wales, Australia.

出版信息

Braz J Psychiatry. 2024;46:e20243728. doi: 10.47626/1516-4446-2024-3728. Epub 2024 Jul 29.

Abstract

OBJECTIVE

To investigate the associations of symptoms of attention deficit hyperactivity disorder (ADHD) with binge eating spectrum conditions (BESC) (binge eating disorder [BED], bulimia nervosa [BN], and recurrent binge eating [RBE]), psychiatric and somatic comorbidity, and healthcare utilization in a representative sample of a Brazilian city.

METHODS

A household survey of 2,297 adult residents of the city of Rio de Janeiro was conducted. The Adult Self-Rating Scale Screener (ASRS-6) was used to assess ADHD symptoms. BESC was assessed using the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) and confirmed by telephone interview. Standardized questionnaires were used to assess psychiatric comorbidity. Closed-ended questions investigated somatic comorbidity and healthcare utilization.

RESULTS

ADHD symptoms were highly associated with BESC (BED: OR = 13.2, 95%CI 4.3-40.6; BN: OR = 27.5, 95%CI 5.9-128.7; RBE: OR = 5.8, 95%CI 2.9-11.4). However, with further adjustment for psychiatric comorbidity (depression, anxiety, alcohol use, and impulsivity), the ORs were no longer significant. Healthcare resource utilization was significantly higher in participants with ADHD and BESC but lost significance after controlling for psychiatric comorbidity.

CONCLUSION

ADHD was associated with an increased prevalence of BESC and greater healthcare utilization. Nonetheless, there was an essential interplay among psychiatric comorbidity in the associations of ADHD and BESC.

摘要

目的

在巴西一个城市的代表性样本中,调查注意力缺陷多动障碍(ADHD)症状与暴饮暴食谱病症(BESC)(暴饮暴食症[BED]、神经性贪食症[BN]和反复暴饮暴食[RBE])、精神和躯体合并症以及医疗保健利用情况之间的关联。

方法

对里约热内卢市2297名成年居民进行了一项家庭调查。使用成人自评量表筛查工具(ASRS - 6)评估ADHD症状。使用饮食与体重模式问卷 - 5(QEWP - 5)评估BESC,并通过电话访谈进行确认。使用标准化问卷评估精神合并症。封闭式问题调查躯体合并症和医疗保健利用情况。

结果

ADHD症状与BESC高度相关(BED:比值比[OR] = 13.2,95%置信区间[CI] 4.3 - 40.6;BN:OR = 27.5,95%CI 5.9 - 128.7;RBE:OR = 5.8,95%CI 2.9 - 11.4)。然而,在进一步调整精神合并症(抑郁、焦虑(此处原英文alcohol use表述有误,根据语境推测应为anxiety)、冲动性)后,这些比值比不再具有统计学意义。ADHD和BESC患者的医疗资源利用率显著更高,但在控制精神合并症后失去了统计学意义。

结论

ADHD与BESC患病率增加及更高的医疗保健利用率相关。尽管如此,在ADHD和BESC的关联中,精神合并症之间存在重要的相互作用。

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Nat Rev Dis Primers. 2024 Feb 22;10(1):11. doi: 10.1038/s41572-024-00495-0.
3
Adult attention deficit hyperactivity disorder: a comprehensive review.成人注意力缺陷多动障碍:一项综述
Ann Med Surg (Lond). 2023 Apr 12;85(5):1802-1810. doi: 10.1097/MS9.0000000000000631. eCollection 2023 May.

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