title: Association between attention-deficit/hyperactivity disorder and bulimia nervosa: analysis of 4 case-control studies.
abstract: BACKGROUND
  Impulsivity is a common feature of attention-deficit/hyperactivity disorder (ADHD), and evidence suggests that impulsivity traits may be an indicator of poor prognosis for individuals with bulimia nervosa. To identify whether there is an association between ADHD and bulimia nervosa, the authors systematically examined data from children and adults with and without ADHD.
  
  
  METHODS
  We systematically identified rates of bulimia nervosa in individuals with and without ADHD (DSM-III-R criteria) in our 2 large pediatric and 2 large adult samples (N = 522 children, 742 adults). Subjects were assessed from the late 1980s to February 1999.
  
  
  RESULTS
  In the 2 samples of adults with and without ADHD, significantly greater rates of bulimia nervosa were identified in women with versus without ADHD (12% vs. 3%, p < .05 for 1 sample and 11% vs. 1%, p < .05 for the other sample). No significant differences in rates of bulimia nervosa were identified in men or children with ADHD when compared to sex-matched control subjects.
  
  
  CONCLUSIONS
  Although preliminary and requiring further confirmation, these findings suggest that ADHD may be associated with bulimia nervosa in some women. If confirmed, this association between bulimia nervosa and ADHD could have important clinical and therapeutic implications.
authors.affiliation: Clinical and Research Program in Pediatric Psychopharmacology at Massachusetts General Hospital and Harvard Medical School, Boston, Mass, USA.
authors.forename: Craig B H
authors.initials: CB
authors.lastname: Surman
authors.forename: Edin T
authors.initials: ET
authors.lastname: Randall
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology*; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D017678:Sex Distribution; D012737:Sex Factors