Association between obesity and attention deficit hyperactivity disorder in children at a tertiary care outpatient setting: A comparative study

A Ellepola,N Gunawardena,G S Wijethunge

doi:10.4038/sljpsyc.v11i1.8226

Abstract

BackgroundAs the prevalence of childhood overweight and obesity increases in developing countries, it is important to identify associated morbidity. Attention deficit hyperactivity disorder (ADHD) has been recently recognized as one such comorbidity in this group. The current study describes the prevalence of ADHD among obese and non-obese children attending outpatient clinics at Lady Ridgeway Hospital (LRH), Sri Lanka. AimsThe main focus of this study was to explore the association between ADHD and obesity in Sri Lankan children. MethodologyThis was a comparative cross sectional study of 209 children aged 6-12 years attending the outpatient department, and the outpatient clinic for obese children at Lady Ridgeway Hospital for Children, Colombo. Participant height and weight was measured and body mass index (BMI) was calculated. Obesity was defined as a BMI of more than 95th centile as per the reference charts. Demographic data was collected using a prepared format and assessment of ADHD was carried out based on DSM IV criteria using the K-SADS PL. ResultsThe prevalence of ADHD among obese participants was 17.1% (n=18), compared to 5.7% (n=6) among the non-obese, and this difference was statistically significant. The combined type ADHD was the most common sub type, followed by the predominantly hyperactive-impulsive. There was a male preponderance with regards to the diagnosis of ADHD. ConclusionsThis study shows that the rate of ADHD is higher among children with obesity, compared to the non-obese. Reasons behind this co-morbidity are unknown. If replicated in future studies, these findings will have important implications in the prevention and management of ADHD in this population group.

Highlights

As the prevalence of childhood overweight and obesity increases in developing countries, it is important to identify associated morbidity
This study shows that the rate of Attention deficit hyperactivity disorder (ADHD) is higher among children with obesity, compared to the non-obese
The findings of this study indicate that children with obesity have a statistically higher prevalence of ADHD when compared with non-obese children (p=0.01)

Summary

Introduction

As the prevalence of childhood overweight and obesity increases in developing countries, it is important to identify associated morbidity. The current study describes the prevalence of ADHD among obese and non-obese children attending outpatient clinics at Lady Ridgeway Hospital (LRH), Sri Lanka. International studies report that the prevalence of ADHD among children aged 4-17 years increased from 7.8% to 9.5% during the period 2003-2007, representing a 21.8% increase in patient numbers [3]. A Sri Lankan study conducted among 37 children attending the Child guidance Clinic at Lady Ridgeway Hospital for Children (LRH) reported a male preponderance of ADHD, with a mean age was 6.5 years [5]. Perera et al in their study of 34 children aged 3-10 years attending an ENT service in a tertiary care children’s hospital with selfinserted foreign bodies, reported that 14.3% of the children had ADHD [6]

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Results

Discussion

Conclusion