Abstract
IntroductionLittle is known about the contribution of impulsivity, inattention and comorbid attention deficit/hyperactivity disorder (ADHD) in the development and maintenance of bulimia nervosa (BN). In particular, their specific contribution to disordered eating symptoms and whether they have additive effects to the general psychopathological burden remains unclear.MethodsFifty-seven female patients seeking treatment for BN and 40 healthy controls completed diagnostic questionnaires and interviews that investigated: a) ADHD, b) impulsivity, c) eating disorders and d) general psychopathology. Attentional processes and impulsivity were assessed by a comprehensive computer-based neuropsychological battery.ResultsTwenty-one percent of patients with BN met the clinical cut-off for previous childhood ADHD compared to 2.5% of healthy controls. Adult ADHD according to DSM IV was also more prevalent in patients with BN, with an odds ratio of 4.2. Patients with BN and previous childhood ADHD were more impulsive and inattentive than patients with BN alone. These patients also displayed more severely disordered eating patterns and more general psychopathological symptoms compared with those without ADHD. Severity of eating disorder symptoms was better explained by inattentiveness than by either impulsivity or hyperactivity.DiscussionOur data suggest an elevated rate of former childhood and current ADHD-symptoms in treatment-seeking patients with BN. Stronger impulsivity and inattention associated with more severe neuropsychological deficits and eating disorder symptoms indicate an additive risk that is clinically relevant for these patients. Thus, clinicians should identify comorbid patients who might profit from additional ADHD-specific treatments.
Highlights
Little is known about the contribution of impulsivity, inattention and comorbid attention deficit/hyperactivity disorder (ADHD) in the development and maintenance of bulimia nervosa (BN)
We found that 10.5% of patients scored above the cutoff on all three ADHD measures compared to 2.5% of healthy controls (HC)
The combination of childhood and current ADHD is required to meet a diagnosis of adult ADHD according to the DSM-IV; participants must show continuous symptoms from childhood to adulthood
Summary
Little is known about the contribution of impulsivity, inattention and comorbid attention deficit/hyperactivity disorder (ADHD) in the development and maintenance of bulimia nervosa (BN). Their specific contribution to disordered eating symptoms and whether they have additive effects to the general psychopathological burden remains unclear. Recent evidence suggests that bulimia nervosa (BN) has common clinical features with attention deficit/hyperactivity disorder (ADHD) and that ADHD symptoms are more prevalent in patients with BN [1,2,3,4,5,6,7]. If BN and ADHD have an additive effect, comorbid patients might show even higher rates of impulsivity and inattention; comorbid patients may have more severe BN symptoms and general psychopathology than patients with BN alone
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have