title: Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents.
abstract: OBJECTIVE
  Preliminary evidence suggests a comorbidity between attention-deficit/hyperactivity disorder (ADHD) and obesity. This study was carried out to identify the clinical characteristics of obese adolescents with a higher probability of ADHD and advance the understanding of the potential factors underlying the comorbidity between obesity and ADHD. We evaluated the association between ADHD symptoms and bulimic behaviors, depressive and anxiety symptoms, degree of obesity, pubertal stage, age and gender in a clinical sample of obese adolescents.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Ninety-nine severely obese adolescents aged 12-17 years.
  
  
  METHODS
  Subjects filled out the Bulimic Investigatory Test, Edinburgh, the Beck Depression Inventory and the State-Trait Anxiety Inventory for Children. Their parents completed the Conners Parent Rating Scale, which assesses ADHD symptoms. The degree of overweight was expressed as body mass index-z score. Puberty development was clinically assessed on the basis of Tanner stages.
  
  
  RESULTS
  Bulimic behaviors were significantly associated with ADHD symptoms after controlling for depressive and anxiety symptoms. The degree of overweight, pubertal stage, age and gender were not significantly associated with ADHD symptoms.
  
  
  CONCLUSIONS
  Obese adolescents with bulimic behaviors may have a higher probability to present with ADHD symptoms independently from associated depressive or anxiety symptoms. The degree of overweight, pubertal stage, age and gender might not be useful for detecting obese adolescents with ADHD symptoms. Therefore, we suggest systematic screening for ADHD in obese adolescents with bulimic behaviors. Further studies are needed to understand which specific dimension of ADHD primarily accounts for the association with bulimic behaviors. Future research should also investigate the causal link between bulimic behaviors and ADHD and explore potential common neurobiological alterations. This may lead to a better understanding of the effectiveness of stimulants for the treatment of bulimic behaviors in obese subjects.
authors.affiliation: AP-HP, Service de Psychopathologie de l'Enfant et de l'Adolescent, Hôpital Robert Debré, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Cortese
authors.forename: P
authors.initials: P
authors.lastname: Isnard
authors.forename: M L
authors.initials: ML
authors.lastname: Frelut
authors.forename: G
authors.initials: G
authors.lastname: Michel
authors.forename: L
authors.initials: L
authors.lastname: Quantin
authors.forename: A
authors.initials: A
authors.lastname: Guedeney
authors.forename: B
authors.initials: B
authors.lastname: Falissard
authors.forename: E
authors.initials: E
authors.lastname: Acquaviva
authors.forename: B
authors.initials: B
authors.lastname: Dalla Bernardina
authors.forename: M C
authors.initials: MC
authors.lastname: Mouren
mesh_terms: D000293:Adolescent; D000886:Anthropometry / Q000379:methods; D001007:Anxiety / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D001824:Body Constitution; D002032:Bulimia / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011627:Puberty