A study with 191 patients reveal that symptoms of hyperactivity due to the deficit of attention and hyperactivity disorder (ADHD) are associated with more impulsivity and more severity, and probably a worse prognosis in patients with eating disorders.

ADHD in adults is poorly investigated and, although several studies have reported associations between this disorder and abnormal eating behaviour, so far it had not been described associations between ADHD and eating disorders in adults.

The results of the study conducted by researchers from the group of Psychiatry and Mental Health at the Bellvitge Biomedical Research Institute (IDIBELL) and the Unit of Eating Behaviour Disorders of the Bellvitge University Hospital, with the colaboration of the Department of Psychiatry of the Vall d’Hebron University Hospital, have been published in the online edition of the journal BMC Psychiatry.

Impulsivity
ADHD symptoms related to hyperactivity such as impulsivity are very present in patients with eating disorders who participated in the study, but not in everyone, as explained Fernando Fernández-Aranda, head of the Unit of Eating Behavior Disorders of the Bellvitge University Hospital and IDIBELL researcher. These disorders “are found mainly in patients with a more impulsive personality: people suffering bulimia, binge eating disorders and unspecific eating disorders. On the other hand, more restrictive anorexic patients and those with more ability to control themselves do not show these symptoms.”

This research has allowed to develop a model that could be clinically useful for early detection of risk factors which could lead to an eating disorder.

ADHD symptoms are positively associated with impulsive personality traits and age. More impulsive and older patients have an increased risk of developing an eating disorder. Impulsivity is also associated with a greater severity of the disorder.

Moreover, these impulsivity ADHD symptoms are associated with low self-direction, a character trait that involves the ability to planning and achieving objectives in the medium and long-term. “So, patients with ADHD symptoms also have a worse prognosis because it is harder for them to be able to accomplish a treatment”, says Fernández-Aranda.

Reward system
According to Fernández-Aranda, this model will be useful not only in the clinic but also for investigating brain circuits that regulate the reward system and that are similar in several behavioural pathologies such as eating disorders, pathological gambling and other behavioural addictions.

Article reference
Fernández-Aranda F., Agüera Z., Castro R., Jiménez-Murcia S., Ramos-Quiroga J.A., Bosch R., Fagundo A.B., Granero R., Penelo E., Claes L., Sánchez I., Riesco N., Casas M. and Menchon J.M. AHDH symtomatology in eating disorders: a secondary psycopathological measure of severity? BMC Psyquiatry 2013, 13:166. Doi: 10.1186/1471-244X-13-166.

More information
Bulimia. Eating behaviour disorder that primarily affects women between 18 and 30 concerned about their image. They usually start a diet to lose weight but they lose control and start shortly episodes of binge eating several times a day. After suffering the loss of control, they look for ways to compensate: 80% of them vomit and the rest make exercise disproportionately or restrict food for a while. The process is repeated up to seven or eight vomiting-binge episodes per day.

Binge Eating Disorder. The 90-95% of patients suffering from this eating disorder are obese persons who use food as an escape valve. Faced with emotional problems, they lose control and eat compulsively. They do not enjoy food like other obese people do.

Anorexia. Eating behaviour disorder that affects women between 14 and 30 years. It is characterized by an excessive preoccupation with the image and a distorted self-image. The affected follow a strict diet to lose weight. They can lose up to 15% of their normal weight and are afraid of gaining weight. 40% of the cases are restrictive, the rest combines binge eating and vomiting.

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Institut d’Investigació Biomèdica de Bellvitge