Attention-deficit/hyperactivity disorder (ADHD) in adult obese patients referred to bariatric surgery

Abstract

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by symptoms of inattention, hyperactivity, and impulsivity, which only rarely remits in adulthood[1]. A positive association between ADHD and obesity has been repeatedly observed, especially in adult samples[ 2]. However, only a few studies investigated the prevalence and correlates of ADHD in obese patients seeking bariatric treatment[3,4]. Objective(s): Our study was aimed to examine the prevalence of probable ADHD comorbidity in a sample of obese patients referred for bariatric surgery. Secondly, we sought to characterize differences in eating behaviour between obese subjects with and without probable ADHD. Method(s): The study sample was composed of 110 adult obese patients (BMI >= 30 kg/m2) consecutively referred for bariatric surgery to the Obesity Center of the Endocrinology Unit in Pisa University Hospital between November 2010 and May 2012. Probable ADHD was identified using a recently developed screening scale based on items selected from Symptom Check-List-90-R (SCL-90-R)[5]. The extent of binge-eating/purging and night-eating behaviours were respectively estimated using the Bulimic Investigatory Test, Edinburgh (BITE)[6] and the Night-eating Questionnaire (NEQ)[7].Wilcoxon test was used for statistical comparisons, with a significance level of p<0.05 set for all tests. Result(s): Probable ADHD was found in 14 subjects (12.7%, 95% CI=7.1-20.4%). Patients with probable ADHD showed significantly higher BITE symptomscore (20.4+/-9.3 vs. 12.1+/-7.5, r=0.31, p=0.001) and NEQ total score (16.1+/-9.2 vs. 9.5+/-3.9, r=0.27, p=0.005). Conclusion(s): ADHD is a relatively common comorbidity in obese patients seeking bariatric treatment, which is positively associated with disordered eating habits, such as binge-eating/purging and night-eating behaviours.