Are subjects with criteria for adult attention-deficit/ hyperactivity disorder doing worse after bariatric surgery? A case-control study.
BACKGROUND
There is an increasing awareness of the strong associations between obesity and adult attention- deficit/hyperactivity disorder (ADHD), with high rates of ADHD (26-61%) in patients seeking weight loss.


OBJECTIVE
To determine the frequency of ADHD in a bariatric surgery (BS) sample and investigate whether there were any differences among clinical, analytical and psychological parameters in individuals with criteria for ADHD.


METHODS
Sixty patients (78.3% female, age 46.3±9.8, months since BS 46.28±18.1) who underwent BS, with a minimum follow-up of 18 months, were evaluated cross-sectionally. Initial and current BMI, eating patterns, comorbidity, socio-demographic and biochemical parameters were recorded. For the screening of ADHD, ADHD self rating scale-v1.1 was administered.


RESULTS
Nineteen individuals (31.6%) had a positive screening for ADHD. This group had higher levels of HDL-cholesterol (62.8±17.3 mg/dl vs 53.5±9.9 mg/dl; p=0.011) and Apo-A (177.7±28.4 mg/dl vs 154.9±34.7 mg/ dl; p=0.015), and an increased consumption of lipids (42.2±7.1% vs 36.7±8.3%; p=0.019). Subjects with ADHD symptoms had more difficulties in following visits after BS (52.6% vs 24.3%; p= 0.011).We could not find any differences in achieved BMI, depressive symptoms or quality of life.


CONCLUSIONS
Patients who met criteria for ADHD face significant difficulties with compliance in follow-up, but we could not find differences in major clinical outcomes. Surprisingly, these patients could have a protective lipid profile.
Endocrinology and Nutrition Department. Hospital Son LLàtzer, University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma.. jnicolauramis@gmail.com.
Joana
J
Nicolau
Endocrinology and Nutrition Department. Hospital Son LLàtzer, University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma.. layalaco@hotmail.com.
Luisa
L
Ayala
Endocrinology and Nutrition Department. Hospital Son LLàtzer, University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma.. cfrances@hsll.es.
Carla
C
Francés
Endocrinology and Nutrition Department. Hospital Son LLàtzer, University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma.. psanchis@hsll.es.
Pilar
P
Sanchís
Endocrinology and Nutrition Department. Hospital Son LLàtzer, University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma.. ipzubill@hsll.es.
Ivana
I
Zubillaga
Surgery Department.. spascual@hsll.es.
Salvador
S
Pascual
Hormonal Laboratory Department. Hospital Son Llàtzer. Spain.. rfortuny@hsll.es.
Regina
R
Fortuny
Endocrinology and Nutrition Department. Hospital Son LLàtzer, University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma.. lmasmiquel@gmail.com.
Lluís
L
Masmiquel
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000097:blood / Q000150:complications* / Q000523:psychology; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016022:Case-Control Studies; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications* / Q000523:psychology / Q000601:surgery; D010349:Patient Compliance; D011184:Postoperative Period; D063189:Symptom Assessment; D014815:Vitamins / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D020738:Leptin; D008055:Lipids; D014815:Vitamins; D006710:Homocysteine; D006854:Hydrocortisone