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Norton B, Sheen J, Burns L, Enticott PG, Fuller-Tyszkiewicz M, Kirkovski M. Overlap of eating disorders and neurodivergence: the role of inhibitory control. BMC Psychiatry 2024; 24:454. [PMID: 38890597 PMCID: PMC11186180 DOI: 10.1186/s12888-024-05837-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Difficulties with inhibitory control have been identified in eating disorders (EDs) and neurodevelopmental disorders (NDs; including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder), and there appear to be parallels between the expression of these impairments. It is theorised that impairments in inhibitory control within NDs may represent a unique vulnerability for eating disorders (EDs), and this same mechanism may contribute to poorer treatment outcomes. This review seeks to determine the state of the literature concerning the role of inhibitory control in the overlap of EDs and neurodivergence. METHOD A scoping review was conducted to summarise extant research, and to identify gaps in the existing knowledge base. Scopus, Medline, PsycInfo, Embase, and ProQuest were systematically searched. Studies were included if the study measured traits of ADHD or autism, and symptoms of ED, and required participants to complete a performance task measure of inhibitory control. Where studies included a cohort with both an ND and ED, these results had to be reported separately from cohorts with a singular diagnosis. Studies were required to be published in English, within the last 10 years. RESULTS No studies explored the relationship between autism and EDs using behavioural measures of inhibitory control. Four studies exploring the relationship between ADHD and EDs using behavioural measures of inhibitory control met selection criteria. These studies showed a multifaceted relationship between these conditions, with differences emerging between domains of inhibitory control. ADHD symptoms predicted poorer performance on measures of response inhibition in a non-clinical sample; this was not replicated in clinical samples, nor was there a significant association with EDs. Both ADHD and ED symptoms are associated with poor performance on attentional control measures; where these diagnoses were combined, performance was worse than for those with a singular diagnosis of ADHD. This was not replicated when compared to those with only ED diagnoses. CONCLUSION Impairments in attentional control may represent a unique vulnerability for the development of an ED and contribute to poor treatment outcomes. Further research is needed to explore the role of inhibitory control in EDs, ADHD and autism, including the use of both self-report and behavioural measures to capture the domains of inhibitory control.
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Affiliation(s)
- Bethany Norton
- School of Psychology, Deakin University, Geelong, Australia.
| | - Jade Sheen
- School of Psychology, Deakin University, Geelong, Australia
| | - Lewis Burns
- School of Psychology, Deakin University, Geelong, Australia
| | | | | | - Melissa Kirkovski
- School of Psychology, Deakin University, Geelong, Australia.
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.
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2
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Lanoye A, Adams E, Fuemmeler BF. Obesity and Attention-Deficit Hyperactivity Disorder. Curr Top Behav Neurosci 2022; 57:221-241. [PMID: 35505058 DOI: 10.1007/7854_2022_337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
An association between ADHD and obesity has been established throughout the past 20 years via animal model experiments and both correlational and longitudinal studies in humans. However, much remains to be determined regarding causality, developmental course, and effective treatments targeting both conditions. This chapter provides an overview and update on the current state of the science on the relationship between obesity and ADHD; expands the scope of the connection between obesity and ADHD to include behavioral components important to weight regulation - i.e., physical activity, eating behaviors, and sleep; and presents applications of these findings to treatment approaches and future directions.
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Affiliation(s)
- Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth Adams
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
- Research Center for Child Well-Being, University of South Carolina, Columbia, SC, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
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3
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Mestre-Bach G, Steward T, Potenza MN, Granero R, Fernández-Aranda F, Mena-Moreno T, Magaña P, Vintró-Alcaraz C, Del Pino-Gutiérrez A, Menchón JM, Jiménez-Murcia S. The Role of ADHD Symptomatology and Emotion Dysregulation in Gambling Disorder. J Atten Disord 2021; 25:1230-1239. [PMID: 31884864 DOI: 10.1177/1087054719894378] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objectives: Although emotion regulation deficits have been implicated in gambling disorder and ADHD, the interplay between these factors has yet to be systematically studied. We examined relationships between ADHD symptoms, emotion regulation, and gambling disorder severity in a sample of treatment-seeking gambling disorder patients (n = 98). We also examined clinical differences between patients with and without ADHD symptomatology. Method: Structural equation modeling (SEM) evaluated direct and indirect effects of ADHD and emotion regulation on gambling disorder severity. Results: Significant correlations between ADHD symptomatology and emotion regulation and between emotion regulation and gambling disorder severity were identified. Differences in emotion regulation were found between gambling disorder patients with and without ADHD symptomatology. Path analysis revealed emotion regulation to be a mediator between ADHD and gambling disorder. Conclusion: Our findings indicate the presence of ADHD symptomatology to be associated with greater severity of gambling disorder and greater emotional dysregulation.
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Affiliation(s)
- Gemma Mestre-Bach
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Yale School of Medicine, New Haven, CT, USA
| | - Trevor Steward
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,The University of Melbourne, Parkville, Victoria, Australia
| | - Marc N Potenza
- Yale School of Medicine, New Haven, CT, USA.,Connecticut Council on Problem Gambling, Wethersfield, USA.,Connecticut Mental Health Center, New Haven, USA
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Universitat Autònoma de Barcelona, Spain
| | - Fernando Fernández-Aranda
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,University of Barcelona, Spain
| | - Teresa Mena-Moreno
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Pablo Magaña
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Pompeu Fabra University, Barcelona, Spain
| | - Cristina Vintró-Alcaraz
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | | | - José M Menchón
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,University of Barcelona, Spain.,CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,University of Barcelona, Spain
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4
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Baraskewich J, Climie EA. The relation between symptoms of ADHD and symptoms of eating disorders in university students. The Journal of General Psychology 2021; 149:405-419. [PMID: 33480309 DOI: 10.1080/00221309.2021.1874862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
There is evidence to suggest an association between Attention-Deficit/Hyperactivity Disorder (ADHD) and eating disorders (EDs). As those with subclinical symptoms of ADHD or ED often experience impairment, this cross-sectional study examined the relationship between ADHD symptoms and ED symptoms in a predominately subclinical undergraduate population. Students (n = 133; 80% female) completed questionnaires measuring ADHD and ED symptomatology. The relation between overall ADHD symptoms and ED symptoms was examined using linear regression; findings indicated that higher ADHD symptoms significantly predicted higher ED symptoms. When symptoms of both disorders were further delineated, inattentive ADHD symptoms consistently predicted higher ED symptoms (bulimia, body dissatisfaction, and drive for thinness). A number of mechanisms may explain the association between ADHD and ED symptoms, including shared executive function deficits, poor emotion regulation, and mood challenges. These mechanisms may have clinical relevance in ADHD and ED treatment and prevention efforts.
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5
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Şahan E, Zengin Eroğlu M, Sertçelik S. Eating behaviors, depression, and anxiety levels of pre bariatric surgery patients with obesity comorbid with or without Attention deficit and hyperactivity disorder: ADHD or Major Depression? Which is more related with eating behaviors? Brain Behav 2021; 11:e01915. [PMID: 33118314 PMCID: PMC7821566 DOI: 10.1002/brb3.1915] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/02/2020] [Accepted: 10/09/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE A high rate of attention deficit and hyperactivity disorder (ADHD) has been reported in patients undergoing obesity treatment. It is controversial whether ADHD solely or its comorbid disorders account for eating behaviors associated with obesity. METHODS After presurgery psychiatric assessment, 100 severely obese patients (50 with ADHD and 50 without ADHD) were administered Adult Attention Deficit Hyperactivity Disorder Self-Report Scale(ASRS), Wender Utah Rating Scale(WURS), Three-Factor Eating Questionnaire(TFEQ), and Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI). RESULTS Patients with obesity and ADHD had significantly greater emotional eating, susceptibility to hunger, depression, and anxiety but less restraint of eating scores than those without ADHD. Disinhibition of eating scores and presence of Binge Eating Disorder(BED) did not differ significantly between ADHD and non-ADHD groups. Obese patients with major depression had significantly higher ASRS, WURS, TFEQ, BAI scores, disinhibition of eating control, emotional eating, susceptibility to hunger, and diagnosis of BED than nondepressed ones. CONCLUSIONS Major depression and anxiety disorder have associations with disinhibition of eating control, emotional eating, susceptibility to hunger and BED, ADHD. Disinhibition of eating and BED did not differ according to the presence of ADHD; thus, depression was associated with eating control on more constructs than ADHD in our study.
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Affiliation(s)
- Ebru Şahan
- Department of PsychiatryMarmara UniversityİstanbulTurkey
| | - Meliha Zengin Eroğlu
- Department of PsychiatryHaydarpaşa Numune Training and Research HospitalİstanbulTurkey
| | - Sencan Sertçelik
- Department of PsychiatryHaydarpaşa Numune Training and Research HospitalİstanbulTurkey
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6
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Does ADHD Symptomatology Influence Treatment Outcome and Dropout Risk in Eating Disorders? A longitudinal Study. J Clin Med 2020; 9:jcm9072305. [PMID: 32698514 PMCID: PMC7408799 DOI: 10.3390/jcm9072305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/08/2020] [Accepted: 07/15/2020] [Indexed: 12/28/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and its symptoms have been shown to be present in patients with eating disorders (EDs) and are associated with increased psychopathology and more dysfunctional personality traits. This study aimed to assess if the presence of ADHD symptoms in patients with EDs affects their short and long-term therapy outcome. A total of 136 consecutively treated ED patients were considered in this study. Baseline pre-treatment evaluation included the Adult ADHD Self-Report Scale (ASRS v1.1) for ADHD symptoms and the assessment of eating symptomatology using the Eating Disorders Inventory (EDI-2). Treatment outcome was evaluated in terms of ED symptoms after cognitive behavioral therapy (CBT) and dropout rate during treatment. Furthermore, we evaluated ED symptoms in treatment completers after a follow-up of 8 years on average. Path analyses assessed the potential mediational role of the EDI-2 total score in the relationship between ADHD and treatment outcome. Results showed that baseline symptoms of ADHD indirectly affected treatment outcome after CBT; the ASRS positive screening was related to higher eating symptomatology (standardized coefficient B = 0.41, p = 0.001, 95% CI: 0.26 to 0.55), and the presence of high ED levels contributed to the increase of dropout (B = 0.15, p = 0.041, 95% CI: 0.03 to 0.33) and a worse treatment outcome (B = 0.18, p = 0.041, 95% CI: 0.01 to 0.35). No direct effect was found between the ASRS positive screening with the risk of dropout (B = -0.08, p = 0.375) and worse treatment outcome (B = -0.07, p = 0.414). These results suggest the relevance of identifying specific treatment approaches for patients with ADHD symptoms and severe eating symptomatology.
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7
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Schaumberg K, Brosof LC, Lloyd EC, Yilmaz Z, Bulik CM, Zerwas SC, Micali N. Prospective associations between childhood neuropsychological profiles and adolescent eating disorders. EUROPEAN EATING DISORDERS REVIEW 2020; 28:156-169. [PMID: 31994257 DOI: 10.1002/erv.2721] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 12/21/2019] [Accepted: 12/30/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Cross-sectional associations between eating disorders (EDs) and deficits in neuropsychological functioning have been well documented; however, limited research has examined whether neuropsychological functioning is prospectively associated with EDs. The current study investigated prospective associations between neuropsychological functioning in childhood (ages 8 and 10) and ED behaviours and disorders in adolescence (at ages 14, 16, and 18 years) in a population-based sample. METHOD Participants (N = 4,803) were children enrolled in the Avon Longitudinal Study of Parents and Children, a population-based, prospective study of women and their children. Regression methods tested associations between facets of neuropsychological functioning (attention, working memory, and inhibition) and eating disorder symptoms and diagnoses. RESULTS Better scores on working memory tasks in childhood were associated with decreased risk of fasting but increased risk of excessive exercise during adolescence. Better inhibitory control was associated with decreased risk for disordered eating at age 14, and attentional difficulties were associated with increased risk for binge eating disorder during adolescence among boys but not girls. CONCLUSIONS Neuropsychological functioning may enhance risk for disordered eating behaviours in specific ways. Overall, effect sizes were small, and results did not support global associations between neuropsychological differences and ED risk in this sample.
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Affiliation(s)
- Katherine Schaumberg
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Leigh C Brosof
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky
| | - E Caitlin Lloyd
- School for policy studies, University of Bristol, Bristol, UK
| | - Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Stephanie C Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, New York.,Institute of Child Health, University College London, London, UK
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8
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Davico C, Amianto F, Gaiotti F, Lasorsa C, Peloso A, Bosia C, Vesco S, Arletti L, Reale L, Vitiello B. Clinical and personality characteristics of adolescents with anorexia nervosa with or without non-suicidal self-injurious behavior. Compr Psychiatry 2019; 94:152115. [PMID: 31513949 DOI: 10.1016/j.comppsych.2019.152115] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/16/2019] [Accepted: 08/04/2019] [Indexed: 02/04/2023] Open
Abstract
PURPOSE About one-fifth of patients with anorexia nervosa (AN) engage in non-suicidal self-injury (NSSI). This study examined clinical and temperament profile of female adolescents with both disorders (AN+NSSI) as compared with peers with AN only. METHODS A consecutive sample of 73 female adolescents with AN (mean age: 13.77 years), who had been admitted to inpatient or day-hospital services, received clinical, cognitive, and temperament/character evaluations. Of them, 32 met DSM-5 criteria also for NSSI. Assessments included demographics, standard nutrition parameters, Youth Self-Report (YSR), Wechsler Intelligence Scale for Children IV (WISC-IV), Temperament and Character Inventory (TCI), and Global Assessment of Functioning (GAF). RESULTS No differences were detected between AN+NSSI and AN in demographics, body mass index, or age at onset of AN. AN+NSSI had higher rate of binging and purging, higher YSR scores for both internalizing and externalizing psychopathology, lower total IQ, and lower Self-directedness and Cooperativeness scores. CONCLUSIONS These data suggest that adolescents with AN+NSSI have psychopathological, cognitive and overall character features that differ from patients with AN only. These characteristics may have implications for treatment and outcome.
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Affiliation(s)
- Chiara Davico
- Department of Public Health and Pediatric Sciences, Section of Child and Adolescent Neuropsychiatry, University of Turin, Italy; Department of Pediatrics and Pediatric Sciences, Regina Margherita Pediatric Hospital, Turin, Italy
| | - Federico Amianto
- Department of Pediatrics and Pediatric Sciences, Regina Margherita Pediatric Hospital, Turin, Italy; Neurosciences Department, Psychiatry Section, University of Turin, Italy.
| | - Federica Gaiotti
- Department of Public Health and Pediatric Sciences, Section of Child and Adolescent Neuropsychiatry, University of Turin, Italy
| | - Claudia Lasorsa
- Department of Pediatrics and Pediatric Sciences, Regina Margherita Pediatric Hospital, Turin, Italy
| | - Anna Peloso
- Department of Public Health and Pediatric Sciences, Section of Child and Adolescent Neuropsychiatry, University of Turin, Italy; Department of Pediatrics and Pediatric Sciences, Regina Margherita Pediatric Hospital, Turin, Italy
| | - Chiara Bosia
- Department of Pediatrics and Pediatric Sciences, Regina Margherita Pediatric Hospital, Turin, Italy
| | - Serena Vesco
- Department of Pediatrics and Pediatric Sciences, Regina Margherita Pediatric Hospital, Turin, Italy
| | - Luca Arletti
- Department of Pediatrics and Pediatric Sciences, Regina Margherita Pediatric Hospital, Turin, Italy
| | - Laura Reale
- Department of Public Health and Pediatric Sciences, Section of Child and Adolescent Neuropsychiatry, University of Turin, Italy; Department of Pediatrics and Pediatric Sciences, Regina Margherita Pediatric Hospital, Turin, Italy
| | - Benedetto Vitiello
- Department of Public Health and Pediatric Sciences, Section of Child and Adolescent Neuropsychiatry, University of Turin, Italy; Department of Pediatrics and Pediatric Sciences, Regina Margherita Pediatric Hospital, Turin, Italy
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9
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Attention-deficit/hyperactivity disorder symptoms and psychological comorbidity in eating disorder patients. Eat Weight Disord 2018; 23:513-519. [PMID: 28534123 DOI: 10.1007/s40519-017-0395-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 04/23/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE There is some evidence that eating disorders (ED) and Attention-deficit/hyperactivity disorder (ADHD) share common clinical features and that ADHD might contribute to the severity of eating disorders. A greater understanding of how the presence of comorbid ADHD may affect the psychopathological framework of eating disorder seems of primary importance. The aim of our study was to evaluate rates of ADHD in three ED subgroups of inpatients: anorexia nervosa restricting type (AN-R), anorexia nervosa binge-eating/purging type (AN-BP) and bulimia nervosa (BN). The secondary aim was the evaluation of the associated psychological characteristics. METHOD The sample consisted of 73 females inpatients (mean age 28.07 ± 7.30), all with longstanding histories of eating disorder (ED). The presence of a diagnosis of ADHD was evaluated in a clinical interview based on DSM-IV-TR criteria. The following psychometric instruments were used: the eating attitude test (EAT-40), the Bulimic Investigatory Test, Edinburgh (BITE), the Eating Disorder Inventory (EDI-2), the Wender Utah Rating Scale (WURS), the Brown Attention Deficit Disorder Scale (BADDS), the Hamilton scales for Anxiety (HAM-A) and Depression (HAM-D), and the Barrat Impulsivity Scale (BIS-10). RESULTS Among the three ED subgroups, 13 patients reported comorbidity with ADHD; three in the AN-R subtype, nine in the AN-BP and one in the BN. The remaining 60 patients (n = 34 AN-R; n = 19 AN-BP; n = 7 BN) presented only a diagnosis of ED. The EAT (p = 0.04) and HAM-A (p = 0.02) mean scores were significantly higher in patients with comorbid ADHD. CONCLUSIONS In our study the comorbidity between ADHD and ED appeared to be frequent, particularly among patients with AN-BP. ED inpatients with higher level of anxiety and more abnormal eating attitudes and bulimic symptoms should be assessed for potentially associated ADHD.
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10
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Matheson BE, Eichen DM. A Review of Childhood Behavioral Problems and Disorders in the Development of Obesity: Attention Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, and Beyond. Curr Obes Rep 2018; 7:19-26. [PMID: 29411333 DOI: 10.1007/s13679-018-0293-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Given the high rates of pediatric and adult obesity, it is imperative to identify early risk factors that might contribute to excess weight gain. This review aims to investigate the relationship between childhood behavioral problems with the development and persistence of obesity. Specifically, this review highlights the association of obesity with (1) neurocognitive constructs, such as executive functioning and inhibition/impulsivity, and (2) disorders commonly diagnosed in childhood, including attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). RECENT FINDINGS Consistent evidence supports a relationship between childhood behavioral problems, executive functioning, inhibition/impulsivity, ADHD, and ASD with obesity across the lifespan. Longitudinal studies suggest behavior problems, neurocognitive functioning deficits, and ADHD symptoms in childhood predict weight gain over time. Identifying risk factors in childhood that promote obesity may help develop targeted intervention and prevention programs. Additional research should elucidate mechanisms that account for these relationships.
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Affiliation(s)
- Brittany E Matheson
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, 6363 Alvarado Court, San Diego, CA, 92120, USA.
- Department of Psychiatry, University of California, San Diego, 8950 Villa La Jolla Dr. Suite C-203, San Diego, CA, 92037, USA.
| | - Dawn M Eichen
- Department of Pediatrics, University of California, San Diego, 8950 Villa La Jolla Dr. Suite C-203, San Diego, CA, 92037, USA
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Nazar BP, Trindade AP, Leslie M, Malloy-Diniz LF, Sergeant J, Treasure J, Mattos P. Eating Disorders Impact on Vigilance and Decision Making of a Community Sample of Treatment Naive Attention-Deficit/Hyperactivity Disorder Young Adults. Front Psychiatry 2018; 9:531. [PMID: 30459649 PMCID: PMC6232382 DOI: 10.3389/fpsyt.2018.00531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/05/2018] [Indexed: 01/12/2023] Open
Abstract
Although impulsivity is suggested as a possible link to explain the association of Attention-Deficit/Hyperactivity Disorder (ADHD) with an Eating Disorder (ED), there is little research on how clinical and cognitive/neuropsychological functioning might change when this comorbidity occurs. ADHD individuals are at a higher of developing ED and also obesity. Some research has described the impact of ADHD in clinical treatment-seeking samples of ED patients. Consequently, we investigated how ED impacted on clinical and cognitive variables of a community sample of treatment-naive ADHD individuals. Ninety college students arranged in three groups (ADHD+ED, ADHD only and Controls) were analyzed using semi-structured interviews for ADHD (K-SADS), the Iowa Gambling Task, the Conner's Continuous Performance Test, Digit and Visual span, as well as rating scales for anxiety (STAI), depression (BDI) and impulsivity (BIS-11), and binge eating (BES). We found that ADHD+ED individuals significantly differed from both groups, presenting with a higher body mass index; more hyperactivity-impulsivity symptoms; higher binge eating scores; more omission errors on the Continuous Performance Test; disadvantageous choices on the Iowa Gambling Task. Also, we demonstrated through a moderation/mediation analysis that a greater level of binge eating mediated the increases in body mass index on our sample. There were no significant paths to explain binge-eating severity through changes on any of the neuropsychological tests used. The presence of an ED in normal weight in a community sample of ADHD individuals is associated with higher body mass index and a worse cognitive functioning.
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Affiliation(s)
- Bruno Palazzo Nazar
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | - Monica Leslie
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | | | - Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Paulo Mattos
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,D'Or Institute for Education and Research, Rio de Janeiro, Brazil
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12
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Análisis de los factores ligados al diagnóstico del trastorno por déficit de atención e hiperactividad en la infancia. Neurologia 2017; 32:431-439. [DOI: 10.1016/j.nrl.2016.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/08/2016] [Accepted: 01/26/2016] [Indexed: 11/24/2022] Open
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13
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Rivas-Juesas C, de Dios J, Benac-Prefaci M, Colomer-Revuelta J. Analysis of the factors linked to a diagnosis of attention deficit hyperactivity disorder in children. NEUROLOGÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.nrleng.2016.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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14
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Satiety regulation in children with loss of control eating and attention-deficit/hyperactivity disorder: A test meal study. Appetite 2017; 116:90-98. [DOI: 10.1016/j.appet.2017.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 04/14/2017] [Accepted: 04/14/2017] [Indexed: 11/17/2022]
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15
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Carlucci S, Ivanova I, Bissada H, Tasca GA. Validity and reliability of the attention deficit hyperactivity disorder self-report scale (ASRS-v1.1) in a clinical sample with eating disorders. Eat Behav 2017; 26:148-154. [PMID: 28390269 DOI: 10.1016/j.eatbeh.2017.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/23/2017] [Accepted: 03/29/2017] [Indexed: 11/15/2022]
Abstract
Individuals with eating disorders (EDs) commonly experience comorbid attention deficit hyperactivity disorder (ADHD). The shared features of EDs and ADHD, such as inattention, impulsivity and hyperactivity, may exacerbate ED symptomatology and pose challenges to treatment. It is important to screen patients with EDs for symptoms of ADHD to optimize their treatment outcomes. However, the psychometrics of common measures of ADHD have not yet been examined within an ED population. An example of such a measure is the ADHD self-report scale (ASRS-v1.1) symptom checklist, which identifies the presence of ADHD symptoms. This study reports a psychometric study of the ASRS-v1.1 in a clinical sample of 500 adults with an ED. A confirmatory factor analysis indicated the ASRS-v1.1 maintained its two-factor structure of inattention and impulsivity/hyperactivity. The item loadings demonstrated path invariance across ED diagnostic groups indicating construct validity. Further, the subscales exhibited good internal consistency and they were significantly correlated with other measures of impulsivity indicating convergent validity. The ED sample had significantly higher mean scores than published nonclinical norms indicating predictive validity, but the ASRS-v1.1 scores were not significantly different among ED diagnostic groups. Results suggest the ASRS-v1.1 is a valid and reliable screening tool for identifying symptoms of ADHD among adults seeking treatment for ED.
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Affiliation(s)
| | - Iryna Ivanova
- Ottawa Hospital Research Institute, Ottawa, ON K1G 0H9, Canada; The Ottawa Hospital, 501 Smyth Road, Ottawa, ON K1G 0H9, Canada
| | - Hany Bissada
- Ottawa Hospital Research Institute, Ottawa, ON K1G 0H9, Canada; The Ottawa Hospital, 501 Smyth Road, Ottawa, ON K1G 0H9, Canada
| | - Giorgio A Tasca
- University of Ottawa, 75 Laurier Ave. E, Ottawa, ON K1N 6N5, Canada; Ottawa Hospital Research Institute, Ottawa, ON K1G 0H9, Canada; The Ottawa Hospital, 501 Smyth Road, Ottawa, ON K1G 0H9, Canada.
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16
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Yilmaz Z, Javaras KN, Baker JH, Thornton LM, Lichtenstein P, Bulik CM, Larsson H. Association Between Childhood to Adolescent Attention Deficit/Hyperactivity Disorder Symptom Trajectories and Late Adolescent Disordered Eating. J Adolesc Health 2017; 61:140-146. [PMID: 28734322 PMCID: PMC5726271 DOI: 10.1016/j.jadohealth.2017.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 04/11/2017] [Accepted: 04/12/2017] [Indexed: 01/30/2023]
Abstract
PURPOSE Disordered eating is more prevalent among adolescents with attention deficit/hyperactivity disorder. Both inattention and hyperactivity/impulsivity symptoms show strong associations with disordered eating, but few investigations of these associations have been longitudinal. Thus, we examined the effect of childhood to adolescent inattention and hyperactivity/impulsivity symptom trajectories on late adolescent disordered eating. METHODS We used growth mixture modeling to identify distinct inattention and hyperactivity/impulsivity symptom trajectories (called "classes") across three time points (ages 8-9, 13-14, and 16-17 years) in the Swedish Twin study of CHild and Adolescent Development. The resulting classes were used to predict Eating Disorder Inventory-2 Bulimia, Drive for Thinness, and Body Dissatisfaction subscales at age 16-17 years, with adjustment for sex and body mass index at age 16-17 years. RESULTS The combined inattention and hyperactivity/impulsivity symptom trajectory classes included: a "low symptom" class characterized by low inattention and hyperactivity/impulsivity throughout childhood/adolescence; a "predominantly inattention" class characterized by elevated inattention, but not hyperactivity/impulsivity, throughout childhood/adolescence; a "predominantly hyp/imp" class characterized by elevated hyperactivity/impulsivity, but not inattention, throughout childhood/adolescence; and a "both inattention and hyp/imp" class characterized by elevated inattention and hyperactivity/impulsivity throughout childhood/adolescence. After adjusting for sex and body mass index or sex and anxiety/depression symptoms, the "both inattention and hyp/imp" (vs. "low symptom") class predicted significantly higher Eating Disorder Inventory-2 subscale scores during late adolescence. CONCLUSIONS Increased vigilance for disordered eating among children who have both inattention and hyperactivity/impulsivity symptoms throughout childhood and adolescence could aid in early identification of eating disorders.
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Affiliation(s)
- Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina.
| | - Kristin N Javaras
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina; Division of Women's Mental Health, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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17
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Heal DJ, Hallam M, Prow M, Gosden J, Cheetham S, Choi YK, Tarazi F, Hutson P. Dopamine and μ-opioid receptor dysregulation in the brains of binge-eating female rats - possible relevance in the psychopathology and treatment of binge-eating disorder. J Psychopharmacol 2017; 31:770-783. [PMID: 28376679 DOI: 10.1177/0269881117699607] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Adult, female rats given irregular, limited access to chocolate develop binge-eating behaviour with normal bodyweight and compulsive/perseverative and impulsive behaviours similar to those in binge-eating disorder. We investigated whether (a) dysregulated central nervous system dopaminergic and opioidergic systems are part of the psychopathology of binge-eating and (b) these neurotransmitter systems may mediate the actions of drugs ameliorating binge-eating disorder psychopathology. Binge-eating produced a 39% reduction of striatal D1 receptors with 22% and 23% reductions in medial and lateral caudate putamen and a 22% increase of striatal μ-opioid receptors. There was no change in D1 receptor density in nucleus accumbens, medial prefrontal cortex or dorsolateral frontal cortex, striatal D2 receptors and dopamine reuptake transporter sites, or μ-opioid receptors in frontal cortex. There were no changes in ligand affinities. The concentrations of monoamines, metabolites and estimates of dopamine (dopamine/dihydroxyphenylacetic acid ratio) and serotonin/5-hydroxyindolacetic acid ratio turnover rates were unchanged in striatum and frontal cortex. However, turnover of dopamine and serotonin in the hypothalamus was increased ~20% and ~15%, respectively. Striatal transmission via D1 receptors is decreased in binge-eating rats while μ-opioid receptor signalling may be increased. These changes are consistent with the attenuation of binge-eating by lisdexamfetamine, which increases catecholaminergic neurotransmission, and nalmefene, a μ-opioid antagonist.
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Affiliation(s)
| | | | | | | | | | - Yong K Choi
- 2 Department of Psychiatry and Neuroscience, Harvard Medical School, Belmont, MA, USA
| | - Frank Tarazi
- 2 Department of Psychiatry and Neuroscience, Harvard Medical School, Belmont, MA, USA
| | - Peter Hutson
- 3 Shire Development Inc., Lexington, MA, USA.,4 Neurobiology, Teva Pharmaceuticals, West Chester, PA, USA
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18
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Svedlund NE, Norring C, Ginsberg Y, von Hausswolff-Juhlin Y. Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among adult eating disorder patients. BMC Psychiatry 2017; 17:19. [PMID: 28095885 PMCID: PMC5240294 DOI: 10.1186/s12888-016-1093-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 10/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Very little is known about the prevalence of ADHD symptoms in Bulimia Nervosa and Binge Eating Disorder and even less in other eating disorders. This knowledge gap is of clinical importance since stimulant treatment is proven effective in Binge Eating Disorder and discussed as a treatment possibility for Bulimia Nervosa. The objective of this study was to explore the prevalence and types of self-reported ADHD symptoms in an unselected group of eating disorder patients assessed in a specialized eating disorder clinic. METHODS In total 1165 adults with an eating disorder were assessed with a battery of standardized instruments, for measuring inter alia ADHD screening, demographic variables, eating disorder symptoms and psychiatric comorbidity. Chi-square tests were used for categorical variables and Kruskal-Wallis tests for continuous variables. RESULTS Almost one third (31.3 %) of the patients scored above the screening cut off indicating a possible ADHD. The highest prevalence rates (35-37 %) were found in Bulimia Nervosa and Anorexia Nervosa bingeing/purging subtype, while Eating Disorder Not Otherwise Specified type 1-4 and Binge Eating Disorder patients reported slightly below average (26-31 %), and Anorexia Nervosa restricting subtype patients even lower (18 %). Presence of binge eating, purging, loss of control over eating and non-anorectic BMI were related to results indicating a possible ADHD. Psychiatric comorbidity correlated to ADHD symptoms without explaining the differences between eating disorder diagnoses. CONCLUSIONS There is a high frequency of ADHD symptoms in patients with binge eating/purging eating disorders that motivates further studies, particularly concerning the effects of ADHD medication. The finding that the frequency of ADHD symptoms in anorexia nervosa with binge eating/purging is as high as in bulimia nervosa highlights the need also for this group.
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Affiliation(s)
- Nils Erik Svedlund
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. .,Stockholm Centre for Eating Disorders, att: Nils Erik Svedlund, Wollmar Yxkullsgatan 27 B, 11850, Stockholm, Sweden.
| | - Claes Norring
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden ,Stockholm Centre for Eating Disorders, att: Nils Erik Svedlund, Wollmar Yxkullsgatan 27 B, 11850 Stockholm, Sweden
| | - Ylva Ginsberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden ,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Yvonne von Hausswolff-Juhlin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden ,Stockholm Centre for Eating Disorders, att: Nils Erik Svedlund, Wollmar Yxkullsgatan 27 B, 11850 Stockholm, Sweden
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19
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The Comorbidity of ADHD and Eating Disorders in a Nationally Representative Sample. J Behav Health Serv Res 2016; 42:437-51. [PMID: 25007864 DOI: 10.1007/s11414-014-9422-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Evidence suggests a comorbidity of childhood attention-deficit/hyperactivity disorder (ADHD) and subsequent eating disorders. However, most studies have assessed this comorbidity among patient populations as opposed to nationally representative samples and have not explored differences by subtype of each disorder. The current study aims to investigate the association between both clinical (i.e., diagnosed) and subclinical (i.e., presence of behaviors but not all diagnostic criteria) ADHD and eating disorders via a secondary data analysis of the National Longitudinal Study of Adolescent Health (n = 12,262). Results reveal that those with clinical ADHD are more likely to experience (a) clinical eating disorder, (b) clinical-level binging and/or purging behaviors, and (c) clinical-level restrictive behaviors. Those with subclinical ADHD (both inattentive and hyperactive/impulsive) were more likely to experience subclinical binging and/or purging behaviors but not subclinical restrictive behaviors. Implications of study findings pertain to both secondary/targeted prevention of eating disorders and tertiary prevention via patient-specific treatment plans.
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20
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Nazar BP, Bernardes C, Peachey G, Sergeant J, Mattos P, Treasure J. The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Int J Eat Disord 2016; 49:1045-1057. [PMID: 27859581 DOI: 10.1002/eat.22643] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/07/2016] [Accepted: 10/09/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVE There has been interest in whether people with Attention-Deficit/Hyperactivity Disorder (ADHD) are at higher risk of developing an Eating Disorder (ED). The aim of this study was estimate the size of this association with a meta-analysis of studies. METHODS We retrieved studies following PRISMA guidelines from a broad range of databases. RESULTS Twelve studies fitted our primary aim in investigating ED in ADHD populations (ADHD = 4,013/Controls = 29,404), and five exploring ADHD in ED populations (ED = 1,044/Controls = 11,292). The pooled odds ratio of diagnosing any ED in ADHD was increased significantly, 3.82 (95% CI:2.34-6.24). A similar level of risk was found across all ED syndromes [Anorexia Nervosa = 4.28 (95% CI:2.24-8.16); Bulimia Nervosa = 5.71 (95% CI: 3.56-9.16) and Binge Eating Disorder = 4.13 (95% CI:3-5.67)]. The risk was significantly higher if ADHD was diagnosed using a clinical interview [5.89 (95% CI:4.32-8.04)] rather than a self-report instrument [2.23 (95% CI:1.23-4.03)]. The pooled odds ratio of diagnosing ADHD in participants with ED was significantly increased, 2.57 (95% CI:1.30-5.11). Subgroup analysis of cohorts with binge eating only yielded a risk of 5.77 (95% CI:2.35-14.18). None of the variables examined in meta-regression procedures explained the variance in effect size between studies. DISCUSSION People with ADHD have a higher risk of comorbidity with an ED and people with an ED also have higher levels of comorbidity with ADHD. Future studies should address if patients with this comorbidity have a different prognosis, course and treatment response when compared to patients with either disorder alone. RESUMEN OBJETIVO Ha habido interés en saber si la gente con Trastorno por Déficit de Atención e Hiperactividad (TDAH) están en mayor riesgo de desarrollar un Trastorno de la Conducta Alimentaria (TCA). El objetivo de este estudio fue estimar el tamaño de esta asociación con un meta-análisis de los estudios. Métodos: Recuperamos estudios de una amplia gama base de datos, que siguen los lineamientos PRISMA. Resultados: Doce estudios encajaron con nuestro objetivo primario de investigar los TCA en poblaciones con TDAH (TDAH = 4,013/Controles = 29,404), y 5 exploraron TDAH en poblaciones con TCA (TCA = 1,044/Controles = 11,292). El odds ratio (OR) agrupado de diagnosticar cualquier TCA en el TDAH se incrementó significativamente, 3.82 (95% CI:2.34-6.24). Un nivel de riesgo similar fue encontrado en todos los síndromes de TCA [Anorexia Nervosa = 4.28 (95% CI:2.24-8.16); Bulimia Nervosa = 5.71 (95% CI:3.56-9.16) y Trastorno por Atracón = 4.13 (95% CI: 3-5.67)]. El riesgo fue significativamente mayor si el TDAH fue diagnosticado utilizando una entrevista clínica [5.89 (95% CI:4.32-8.04)] en lugar de un instrumento de auto-reporte [2.23 (95% CI:1.23-4.03)]. El odds ratio (OR) agrupado de diagnosticar TDAH en participantes con TCA fue significativamente incrementado, 2.57 (95% CI:1.30-5.11). El análisis de los subgrupos de cohort con atracones solamente produjo un riesgo de 5.77 (95% CI:2.35-14.18). Ninguna de las variables examinadas en los procedimientos de meta-regresión explicaron la varianza en el tamaño del efecto entre los estudios. Discusión: La gente con TDAH tiene un mayor riesgo de comorbilidad con un TCA y la gente con un TCA también tiene niveles altos de comorbilidad con TDAH. Los estudios futuros deberán abordar si los pacientes con esta comorbilidad tienen diferente pronóstico, curso y respuesta a tratamiento cuando son comparados con pacientes que solamente tienen uno de los trastornos. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016) © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1045-1057).
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Affiliation(s)
- Bruno Palazzo Nazar
- Institute of Psychiatry (IPUB-UFRJ), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IOPPN), King's College, London
| | - Camila Bernardes
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Gemma Peachey
- South London and the Maudsley National Health Trust (SLaM - NHS), London
| | | | - Paulo Mattos
- Institute of Psychiatry (IPUB-UFRJ), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IOPPN), King's College, London.,South London and the Maudsley National Health Trust (SLaM - NHS), London
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21
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Levin RL, Rawana JS. Attention-deficit/hyperactivity disorder and eating disorders across the lifespan: A systematic review of the literature. Clin Psychol Rev 2016; 50:22-36. [PMID: 27693587 DOI: 10.1016/j.cpr.2016.09.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 09/07/2016] [Accepted: 09/21/2016] [Indexed: 12/25/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and eating disorders are common and concerning mental health disorders. There is both empirical and theoretical support for an association between ADHD and eating disorders or disordered eating. This systematic review aims to summarize the extant literature on the comorbidity of ADHD and eating disorders across the lifespan, including the influences of sex, age, eating disorder diagnosis, and potential mediators. A total of 37 peer-reviewed studies on diagnosed ADHD and eating disturbances were identified through key research databases. Twenty-six studies supported a strong empirical association between ADHD and eating disorders or disordered eating. The systematic review findings suggest that children with ADHD are at risk for disordered eating, while adolescents, emerging adults, and adults are at risk for both eating disorders and disordered eating. Methodological considerations, future research, and clinical implications are discussed.
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Affiliation(s)
- Rivka L Levin
- York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
| | - Jennine S Rawana
- York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
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22
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Brewerton TD, Duncan AE. Associations between Attention Deficit Hyperactivity Disorder and Eating Disorders by Gender: Results from the National Comorbidity Survey Replication. EUROPEAN EATING DISORDERS REVIEW 2016; 24:536-540. [PMID: 27480884 DOI: 10.1002/erv.2468] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/09/2016] [Accepted: 07/13/2016] [Indexed: 11/11/2022]
Abstract
Few studies have assessed the association between attention-deficit hyperactivity disorder (ADHD) and eating disorders (ED) separately in men and women, especially in representative samples. Using data from the National Comorbidity Survey Replication, lifetime and past 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders IV, ADHD was compared in men and women with and without diagnoses of Diagnostic and Statistical Manual of Mental Disorders IV ED and any binge eating (BE) using logistic regression models adjusted for gender and age. In both sexes, those with lifetime and past 12-month BE and binge eating disorder had significantly higher prevalence of ADHD than those without BE and binge eating disorder, respectively. Women with lifetime and past 12-month bulimia nervosa and lifetime anorexia nervosa also had significantly higher prevalence of ADHD compared with women without these diagnoses. Given that ADHD invariably began earlier than the ED, ADHD may be an important risk factor for subsequent BE and related ED, and there may be opportunities for intervention among youth with ADHD. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Alexis E Duncan
- Brown School, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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23
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Heal DJ, Goddard S, Brammer RJ, Hutson PH, Vickers SP. Lisdexamfetamine reduces the compulsive and perseverative behaviour of binge-eating rats in a novel food reward/punished responding conflict model. J Psychopharmacol 2016; 30:662-75. [PMID: 27170676 DOI: 10.1177/0269881116647506] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Compulsive and perseverative behaviour in binge-eating, female, Wistar rats was investigated in a novel food reward/punished responding conflict model. Rats were trained to perform the conditioned avoidance response task. When proficient, the paradigm was altered to a food-associated conflict test by placing a chocolate-filled jar (empty jar for controls) in one compartment of the shuttle box. Entry into the compartment with the jar triggered the conditioning stimulus after a variable interval, and foot-shock 10 seconds later if the rat did not leave. Residence in the 'safe' compartment with no jar did not initiate trials or foot-shocks. By frequently entering the chocolate-paired compartment, binge-eating rats completed their 10 trials more quickly than non-binge controls. Binge-eating rats spent a greater percentage of the session in the chocolate-paired compartment, received foot-shocks more frequently, and tolerated foot-shocks for longer periods; all consistent with compulsive and perseverative behaviour. The d-amphetamine prodrug, lisdexamfetamine, has recently received US approval for the treatment of moderate to severe binge-eating disorder in adults. Lisdexamfetamine (0.8 mg/kg po [d-amphetamine base]) decreased chocolate consumption by binge-eating rats by 55% and markedly reduced compulsive and perseverative responding in the model. These findings complement clinical results showing lisdexamfetamine reduced compulsiveness scores in subjects with binge-eating disorder.
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24
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Karaca S, Saleh A, Canan F, Potenza MN. Comorbidity between Behavioral Addictions and Attention Deficit/Hyperactivity Disorder: a Systematic Review. Int J Ment Health Addict 2016. [DOI: 10.1007/s11469-016-9660-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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25
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Davis C, Levitan RD, Kaplan AS, Carter-Major JC, Kennedy JL. Sex differences in subjective and objective responses to a stimulant medication (methylphenidate): Comparisons between overweight/obese adults with and without binge-eating disorder. Int J Eat Disord 2016; 49:473-81. [PMID: 26691428 DOI: 10.1002/eat.22493] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 11/21/2015] [Accepted: 11/22/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to examine sex differences in response to a single dose of a psychomotor-stimulant medication (methylphenidate: MP) and to assess whether expected differences were moderated by binge-eating disorder (BED) status. It is anticipated that findings will shed light on factors that contribute to response variation in the use of stimulant pharmacotherapy to treat BED. METHOD The study employed a double-blind, drug-placebo, cross-over design in overweight/obese adults with BED (n = 90) and without BED (n = 108). Emotional/mood ratings were assessed every 15 minutes after oral administration of the drug/placebo, and appetite, cravings, and consumption were assessed during a laboratory-based snack-food challenge. RESULTS Women reported earlier and more sustained "overall" effects of the drug-including "feeling high"-than the men. There was also a significantly greater suppression in appetite ratings, food cravings, and food consumption from the placebo to the drug condition among the women. Indeed, among men there were no significant differences between the two conditions on any of the food-related variables. BED status also did not moderate any of the drug-placebo differences. DISCUSSION These findings are relevant to the use of stimulant pharmacotherapy for BED, and raise the possibility that overweight/obese men may be relatively less responsive to this form of treatment. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:473-481).
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Affiliation(s)
- Caroline Davis
- Kinesiology & Health Sciences, York University, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada
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26
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Ptacek R, Stefano GB, Weissenberger S, Akotia D, Raboch J, Papezova H, Domkarova L, Stepankova T, Goetz M. Attention deficit hyperactivity disorder and disordered eating behaviors: links, risks, and challenges faced. Neuropsychiatr Dis Treat 2016; 12:571-9. [PMID: 27042070 PMCID: PMC4780667 DOI: 10.2147/ndt.s68763] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often persists in adulthood. It is defined by inattention and/or hyperactivity-impulsivity. ADHD is associated with many comorbidities, including eating disorders (EDs). In the last decade, studies have reported that ADHD is linked with binge EDs, bulimia nervosa, and anorexia nervosa. Many postulates have been proposed to explain the association: 1) impulsive behavior in ADHD patients leads to disordered eating behavior; 2) other psychologic comorbidities present in ADHD patients account for eating behavior; 3) poor eating habits and resulting nutritional deficiencies contribute to ADHD symptoms; and 4) other risk factors common to both ADHD and EDs contribute to the coincidence of both diseases. Additionally, sex differences become a significant issue in the discussion of EDs and ADHD because of the higher incidence of bulimia nervosa and anorexia nervosa in females and the ability of females to mask the symptoms of ADHD. Interestingly, both EDs and ADHD rely on a common neural substrate, namely, dopaminergic signaling. Dopaminergic signaling is critical for motor activity and emotion, the latter enabling the former into a combined motivated movement like eating. This linkage aids in explaining the many comorbidities associated with ADHD. The interconnection of ADHD and EDs is discussed from both a historical perspective and the one based on the revealing nature of its comorbidities.
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Affiliation(s)
- Radek Ptacek
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic; Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - George B Stefano
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic; MitoGenetics Research Institute, MitoGenetics, LLC, Farmingdale, NY, USA
| | - Simon Weissenberger
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Devang Akotia
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Jiri Raboch
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Hana Papezova
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Lucie Domkarova
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Tereza Stepankova
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Michal Goetz
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
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Bleck J, DeBate R, Levin BL, Baldwin J. Underlying Mechanisms and Trajectory of Comorbid ADHD and Eating Disorders: Proposing an Innovative Systems Framework for Informing Research. Int J Ment Health Addict 2015. [DOI: 10.1007/s11469-015-9593-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Clinical, Psychopathological, and Personality Characteristics Associated with ADHD among Individuals Seeking Treatment for Gambling Disorder. BIOMED RESEARCH INTERNATIONAL 2015; 2015:965303. [PMID: 26229967 PMCID: PMC4502275 DOI: 10.1155/2015/965303] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/08/2015] [Indexed: 12/29/2022]
Abstract
Objectives. (1) To assess the current presence of ADHD symptoms among patients seeking treatment for gambling disorder; (2) to explore clinical and sociodemographic differences between patients who score high and low on the measure of ADHD symptoms; (3) to analyze whether the presence of ADHD symptoms is associated with more severe psychopathology and with specific personality traits; (4) to analyze the mediating role of ADHD symptoms in the relationship between novelty seeking and gambling severity. Method. A total of 354 consecutive patients were administered an extensive battery assessing gambling behavior, psychopathology, and personality traits. Results. Male and female gamblers did not differ significantly in their mean scores on the ADHD measure. However, younger participants aged 18–35 scored higher. Higher ADHD scores were also associated with greater severity of gambling disorder and more general psychopathology. Regarding personality traits, high persistence and self-directedness were negatively related to ADHD scores, while in women alone a positive correlation was found between ADHD scores and scores on harm avoidance and self-transcendence. Conclusion. The presence of ADHD symptoms in both male and female gambling disorder patients may act as an indicator of the severity of gambling, general psychopathology, and dysfunctional personality traits.
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Aloi M, Rania M, Caroleo M, Bruni A, Palmieri A, Cauteruccio MA, De Fazio P, Segura-García C. Decision making, central coherence and set-shifting: a comparison between Binge Eating Disorder, Anorexia Nervosa and Healthy Controls. BMC Psychiatry 2015; 15:6. [PMID: 25616812 PMCID: PMC4308856 DOI: 10.1186/s12888-015-0395-z] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 01/15/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Several studies have investigated the cognitive profile in patients with Anorexia Nervosa (AN) and Bulimia Nervosa (BN); on the contrary few studies have evaluated it in patients with Binge Eating Disorder (BED). The purpose of this study was to compare decision making, central coherence and set-shifting between BED and AN patients. METHODS A battery of neuropsychological tests including the Iowa Gambling Task (IGT), the Rey-Osterrieth Complex Figure Test (RCFT), the Wisconsin Card Sorting Test (WCST), the Trial Making Task (TMT) and the Hayling Sentence Completion Task (HSCT) were administered in a sample of 135 women (45 AN, 45 BED, 45 Healthy Controls [HC]). Furthermore, Beck Depression Inventory (BDI) was administered to evaluate depressive symptoms. Years of education, age, Body Mass Index (BMI) and depression severity were considered as covariates in statistical analyses. RESULTS BED and AN patients showed high rates of cognitive impairment compared to HC on the domains investigated; furthermore, the cognitive profile of BED patients was characterised by poorer decision making and cognitive flexibility compared to patients with AN. Cognitive performance was strongly associated with depressive symptoms. CONCLUSIONS In the present sample, two different neurocognitive profiles emerged: a strong cognitive rigidity and a central coherence based on the details was predominant in patients with AN, while a lack of attention and difficulty in adapting to changes in a new situation seemed to better describe patients with BED. The knowledge of the different cognitive profiles of EDs patients may be important for the planning their psychotherapeutic intervention.
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Affiliation(s)
- Matteo Aloi
- Chair of Psychiatry. Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
| | - Marianna Rania
- Chair of Psychiatry. Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
| | - Mariarita Caroleo
- Chair of Psychiatry. Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
| | - Antonella Bruni
- Chair of Psychiatry. Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
| | - Antonella Palmieri
- Chair of Psychiatry. Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
| | | | - Pasquale De Fazio
- Chair of Psychiatry. Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
| | - Cristina Segura-García
- Chair of Psychiatry. Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
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Jiménez-Murcia S, Granero R, Moragas L, Steiger H, Israel M, Aymamí N, Gómez-Peña M, Sauchelli S, Agüera Z, Sánchez I, Riesco N, Penelo E, Menchón JM, Fernández-Aranda F. Differences and Similarities Between Bulimia Nervosa, Compulsive Buying and Gambling Disorder. EUROPEAN EATING DISORDERS REVIEW 2014; 23:111-8. [DOI: 10.1002/erv.2340] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 11/21/2014] [Accepted: 11/24/2014] [Indexed: 12/22/2022]
Affiliation(s)
- Susana Jiménez-Murcia
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III; Madrid Spain
| | - Roser Granero
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III; Madrid Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut; Universitat Autònoma de Barcelona; Barcelona Spain
| | - Laura Moragas
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Howard Steiger
- Douglas Mental Health University Institute; Montreal Canada
| | - Mimi Israel
- Douglas Mental Health University Institute; Montreal Canada
| | - Neus Aymamí
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Sarah Sauchelli
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Zaida Agüera
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Isabel Sánchez
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Nadine Riesco
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Eva Penelo
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut; Universitat Autònoma de Barcelona; Barcelona Spain
| | - José M. Menchón
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Ciber de Salud Mental (CIBERSAM); Instituto Salud Carlos III; Madrid Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III; Madrid Spain
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Dietary-induced binge eating increases prefrontal cortex neural activation to restraint stress and increases binge food consumption following chronic guanfacine. Pharmacol Biochem Behav 2014; 125:21-28. [PMID: 25158105 DOI: 10.1016/j.pbb.2014.08.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 08/13/2014] [Accepted: 08/16/2014] [Indexed: 01/27/2023]
Abstract
Binge eating is a prominent feature of bulimia nervosa and binge eating disorder. Stress or perceived stress is an often-cited reason for binge eating. One notion is that the neural pathways that overlap with stress reactivity and feeding behavior are altered by recurrent binge eating. Using young adult female rats in a dietary-induced binge eating model (30 min access to binge food with or without 24-h calorie restriction, twice a week, for 6 weeks) we measured the neural activation by c-Fos immunoreactivity to the binge food (vegetable shortening mixed with 10% sucrose) in bingeing and non-bingeing animals under acute stress (immobilization; 1 h) or no stress conditions. There was an increase in the number of immunopositive cells in the dorsal medial prefrontal cortex (mPFC) in stressed animals previously exposed to the binge eating feeding schedules. Because attention deficit hyperactive disorder (ADHD) medications target the mPFC and have some efficacy at reducing binge eating in clinical populations, we examined whether chronic (2 weeks; via IP osmotic mini-pumps) treatment with a selective alpha-2A adrenergic agonist (0.5 mg/kg/day), guanfacine, would reduce binge-like eating. In the binge group with only scheduled access to binge food (30 min; twice a week; 8 weeks), guanfacine increased total calories consumed during the 30-min access period from the 2-week pre-treatment baseline and increased binge food consumption compared with saline-treated animals. These experiments suggest that mPFC is differentially activated in response to an immobilization stress in animals under different dietary conditions and chronic guanfacine, at the dose tested, was ineffective at reducing binge-like eating.
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Fernández-Aranda F, Sauchelli S, Pastor A, Gonzalez ML, de la Torre R, Granero R, Jiménez-Murcia S, Baños R, Botella C, Fernández-Real JM, Fernández-García JC, Frühbeck G, Gómez-Ambrosi J, Rodríguez R, Tinahones FJ, Arcelus J, Fagundo AB, Agüera Z, Miró J, Casanueva FF. Moderate-vigorous physical activity across body mass index in females: moderating effect of endocannabinoids and temperament. PLoS One 2014; 9:e104534. [PMID: 25101961 PMCID: PMC4125187 DOI: 10.1371/journal.pone.0104534] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 07/10/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Endocannabinoids and temperament traits have been linked to both physical activity and body mass index (BMI) however no study has explored how these factors interact in females. The aims of this cross-sectional study were to 1) examine differences among distinct BMI groups on daytime physical activity and time spent in moderate-vigorous physical activity (MVPA), temperament traits and plasma endocannabinoid concentrations; and 2) explore the association and interaction between MVPA, temperament, endocannabinoids and BMI. METHODS Physical activity was measured with the wrist-worn accelerometer Actiwatch AW7, in a sample of 189 female participants (43 morbid obese, 30 obese, and 116 healthy-weight controls). The Temperament and Character Inventory-Revised questionnaire was used to assess personality traits. BMI was calculated by bioelectrical impedance analysis via the TANITA digital scale. Blood analyses were conducted to measure levels of endocannabinoids and endocannabinoid-related compounds. Path-analysis was performed to examine the association between predictive variables and MVPA. RESULTS Obese groups showed lower MVPA and dysfunctional temperament traits compared to healthy-weight controls. Plasma concentrations of 2-arachidonoylglyceryl (2-AG) were greater in obese groups. Path-analysis identified a direct effect between greater MVPA and low BMI (b = -0.13, p = .039) and high MVPA levels were associated with elevated anandamide (AEA) levels (b = 0.16, p = .049) and N-oleylethanolamide (OEA) levels (b = 0.22, p = .004), as well as high Novelty seeking (b = 0.18, p<.001) and low Harm avoidance (b = -0.16, p<.001). CONCLUSIONS Obese individuals showed a distinct temperament profile and circulating endocannabinoids compared to controls. Temperament and endocannabinoids may act as moderators of the low MVPA in obesity.
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Affiliation(s)
- Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
- * E-mail: (FF-A); (FFC)
| | - Sarah Sauchelli
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Antoni Pastor
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Pharmacology, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Human Pharmacology and Clinical Neurosciences Research Group, Neuroscience Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Rafael de la Torre
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Human Pharmacology and Clinical Neurosciences Research Group, Neuroscience Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Rosa Baños
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Psychological, Personality, Evaluation and Treatment of the University of Valencia, Valencia, Spain
| | - Cristina Botella
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Basic Psychology, Clinic and Psychobiology of the University Jaume I, Castelló, Spain
| | - Jose M. Fernández-Real
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Diabetes, Endocrinology and Nutrition, Institut d’Investigació Biomèdica de Girona (IdlBGi) Hospital Dr Josep Trueta, Girona, Spain
| | - Jose C. Fernández-García
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain
| | - Gema Frühbeck
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Javier Gómez-Ambrosi
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Roser Rodríguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Diabetes, Endocrinology and Nutrition, Institut d’Investigació Biomèdica de Girona (IdlBGi) Hospital Dr Josep Trueta, Girona, Spain
| | - Francisco J. Tinahones
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain
| | - Jon Arcelus
- Eating Disorders Service, Glenfield University Hospital, Leicester, United Kingdom
| | - Ana B. Fagundo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Zaida Agüera
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Jordi Miró
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Felipe F. Casanueva
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Medicine, Endocrinology Division, Santiago de Compostela University, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
- * E-mail: (FF-A); (FFC)
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Alm PA. Stuttering in relation to anxiety, temperament, and personality: review and analysis with focus on causality. JOURNAL OF FLUENCY DISORDERS 2014; 40:5-21. [PMID: 24929463 DOI: 10.1016/j.jfludis.2014.01.004] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 01/27/2014] [Accepted: 01/31/2014] [Indexed: 05/14/2023]
Abstract
UNLABELLED Anxiety and emotional reactions have a central role in many theories of stuttering, for example that persons who stutter would tend to have an emotionally sensitive temperament. The possible relation between stuttering and certain traits of temperament or personality were reviewed and analyzed, with focus on temporal relations (i.e., what comes first). It was consistently found that preschool children who stutter (as a group) do not show any tendencies toward elevated temperamental traits of shyness or social anxiety compared with children who do not stutter. Significant group differences were, however, repeatedly reported for traits associated with inattention and hyperactivity/impulsivity, which is likely to reflect a subgroup of children who stutter. Available data is not consistent with the proposal that the risk for persistent stuttering is increased by an emotionally reactive temperament in children who stutter. Speech-related social anxiety develops in many cases of stuttering, before adulthood. Reduction of social anxiety in adults who stutter does not in itself appear to result in significant improvement of speech fluency. Studies have not revealed any relation between the severity of the motor symptoms of stuttering and temperamental traits. It is proposed that situational variability of stuttering, related to social complexity, is an effect of interference from social cognition and not directly from the emotions of social anxiety. In summary, the studies in this review provide strong evidence that persons who stutter are not characterized by constitutional traits of anxiety or similar constructs. EDUCATIONAL OBJECTIVES This paper provides a review and analysis of studies of anxiety, temperament, and personality, organized with the objective to clarify cause and effect relations. Readers will be able to (a) understand the importance of effect size and distribution of data for interpretation of group differences; (b) understand the role of temporal relations for interpretation of cause and effect; (c) discuss the results of studies of anxiety, temperament and personality in relation to stuttering; and (d) discuss situational variations of stuttering and the possible role of social cognition.
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Affiliation(s)
- Per A Alm
- Department of Neuroscience, Speech and Language Pathology, Uppsala University, Sweden.
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Ioannidis K, Serfontein J, Müller U. Bulimia nervosa patient diagnosed with previously unsuspected ADHD in adulthood: clinical case report, literature review, and diagnostic challenges. Int J Eat Disord 2014; 47:431-6. [PMID: 24311027 DOI: 10.1002/eat.22231] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2013] [Indexed: 11/07/2022]
Abstract
There is increasing literature suggesting a link between attention-deficit hyperactivity disorder (ADHD) and eating disorders (EDs), especially bulimia nervosa. ADHD is under-diagnosed in girls and children of high intelligence are typically missed. We identified a case of a 23-year-old woman suffering from severe bulimia nervosa and previously unsuspected ADHD in adulthood; we diagnosed and treated her with extended-release methylphenidate. We performed a literature review on the ADHD and bulimia nervosa comorbidity. We discuss the reasons why her ADHD remained undiagnosed and the difficulties in diagnosing ADHD in patients with EDs. We suggest that identifying comorbid ADHD is crucial for these patients and argue for the use of a structured interview, collateral history and investigation of onset of symptoms to establish a diagnosis of ADHD in adults with bulimia nervosa. Comorbidities and overlap of symptomatology need to be taken into account.
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Ramos-Quiroga JA, Nasillo V, Fernández-Aranda F, Casas M. Addressing the lack of studies in attention-deficit/hyperactivity disorder in adults. Expert Rev Neurother 2014; 14:553-67. [DOI: 10.1586/14737175.2014.908708] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gregorowski C, Seedat S, Jordaan GP. A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders. BMC Psychiatry 2013; 13:289. [PMID: 24200300 PMCID: PMC4226257 DOI: 10.1186/1471-244x-13-289] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 07/31/2013] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Research has shown that eating disorder (ED) patients who abuse substances demonstrate worse ED symptomatology and poorer outcomes than those with EDs alone, including increased general medical complications and psychopathology, longer recovery times, poorer functional outcomes and higher relapse rates. This article provides a broad overview of the prevalence, aetiology, assessment and management of co-morbid EDs and substance use disorders (SUDs). REVIEW The co-occurrence of EDs and SUDs is high. The functional relationship between EDs and SUDs vary within and across ED subtypes, depends on the class of substance, and needs to be carefully assessed for each patient. Substances such as caffeine, tobacco, insulin, thyroid medications, stimulants or over the counter medications (laxatives, diuretics) may be used to aid weight loss and/or provide energy, and alcohol or psychoactive substances could be used for emotional regulation or as part of a pattern of impulsive behaviour. A key message conveyed in the current literature is the importance of screening and assessment for co-morbid SUDs and EDs in patients presenting with either disorder. There is a paucity of treatment studies on the management of co-occurring EDs and SUDs. Overall, the literature indicates that the ED and SUD should be addressed simultaneously using a multi-disciplinary approach. The need for medical stabilization, hospitalization or inpatient treatment needs to be assessed based on general medical and psychiatric considerations. Common features across therapeutic interventions include psycho-education about the aetiological commonalities, risks and sequelae of concurrent ED behaviours and substance abuse, dietary education and planning, cognitive challenging of eating disordered attitudes and beliefs, building of skills and coping mechanisms, addressing obstacles to improvement and the prevention of relapse. Emphasis should be placed on building a collaborative therapeutic relationship and avoiding power struggles. Cognitive behavioural therapy has been frequently used in the treatment of co-morbid EDs and SUDs, however there are no randomized controlled trials. More recently evidence has been found for the efficacy of dialectical behavioural therapy in reducing both ED and substance use behaviours. CONCLUSION Future research would benefit from a meta-analysis of the current research in order to better understand the relationships between these two commonly co-occurring disorders.
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Affiliation(s)
- Claire Gregorowski
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Gerhard P Jordaan
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
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Vaz-Leal FJ, Rodríguez-Santos L, García-Herráiz MA, Chimpén-López CA, Rojo-Moreno L, Beato-Fernández L, Ramos-Fuentes MI. The role of depression and impulsivity in the psychopathology of bulimia nervosa. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2013; 7:25-31. [PMID: 23972724 DOI: 10.1016/j.rpsm.2013.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 06/18/2013] [Accepted: 06/20/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The study aimed to analyze the role of depression and impulsivity in the psychopathology of bulimia nervosa (BN). MATERIALS AND METHODS Seventy female patients with DSM-IV BN, purging subtype, were assessed for eating-related symptoms, body dissatisfaction, affective symptoms, impulsivity, and personality traits. Factor analysis and structural equation modeling methods were used for statistical analysis. RESULTS BN appeared as a condition which incorporated 5 general dimensions: a) binge eating and compensatory behaviours; b) restrictive eating; c) body dissatisfaction; d) dissocial personality traits; and e) a cluster of features which was called «emotional instability» The 5 obtained dimensions can be grouped into 2 basic factors: body dissatisfaction/eating behaviour and personality traits/psychopathology. The first one contains the clinical items used for the definition of BN as a clinical condition in the DSM-V and the International Classification of Diseases 10, and reflects the morphology and the severity of the eating-related symptoms. The second dimension includes a cluster of symptoms (depressive symptoms, impulsivity, and borderline, self-defeating and dissocial personality traits) which could be regarded as the «psychopathological core» of BN and may be able to condition the course and the prognosis of BN.
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Affiliation(s)
- Francisco J Vaz-Leal
- Facultad de Medicina, Universidad de Extremadura/Unidad de Trastornos de la Conducta Alimentaria, Complejo Hospitalario Universitario, Servicio Extremeño de Salud, Badajoz, España.
| | - Laura Rodríguez-Santos
- Facultad de Medicina, Universidad de Extremadura/Unidad de Trastornos de la Conducta Alimentaria, Complejo Hospitalario Universitario, Servicio Extremeño de Salud, Badajoz, España
| | - M Angustias García-Herráiz
- Facultad de Medicina, Universidad de Extremadura/Unidad de Trastornos de la Conducta Alimentaria, Complejo Hospitalario Universitario, Servicio Extremeño de Salud, Badajoz, España
| | - Carlos A Chimpén-López
- Facultad de Medicina, Universidad de Extremadura/Unidad de Trastornos de la Conducta Alimentaria, Complejo Hospitalario Universitario, Servicio Extremeño de Salud, Badajoz, España
| | - Luís Rojo-Moreno
- Facultad de Medicina, Universidad de Valencia/Unidad de Trastornos de la Conducta Alimentaria, Hospital La Fe, Valencia, España
| | - Luís Beato-Fernández
- Facultad de Medicina, Unidad de Trastornos de la Conducta Alimentaria, Hospital General de Ciudad Real, Universidad de Castilla-La Mancha, Ciudad Real, España
| | - María Isabel Ramos-Fuentes
- Facultad de Medicina, Universidad de Extremadura/Unidad de Trastornos de la Conducta Alimentaria, Complejo Hospitalario Universitario, Servicio Extremeño de Salud, Badajoz, España
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