الفهرس 
Panoramic view on ADHDOnly 14 pages are availabe for public view
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Abstract
Attention-deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder of childhood with an estimated prevalence of 5-10%. It is a neurocognitive behavioral developmental disorder defined by pervasive and impairing age-inappropriate symptoms of inattention, impulsivity, and/or hyperactivity. And previous studies have demonstrated a relationship between ADHD and eating disorders, particularly binge eating disorders (BED).
BED is the most common type of eating disorders and is characterized by episodic excessive food consumption in a short time without the regular use of inappropriate compensatory behaviors, such as fasting, and excessive exercise. And while previous research has demonstrated that there is a positive correlation between ADHD and BED, it has not been well defined whether the impulsivity domain is a significant mediator of the relationship between ADHD and BED or not.
Impulsivity appears to play a central role in BED, although this relationship has not been completely understood. While previous research has demonstrated that there is a positive correlation between ADHD and BED, it has not been well defined whether the impulsivity domain is a significant mediator of the relationship between ADHD and BED or not.
This study was conducted aiming to identify the rate of occurrence of binge eating disorder in patients with ADHD and to highlight if there is a relation between binge eating, impulsivity and ADHD. We hypothesized that impulsivity could have an important mediating role in the relationship between ADHD symptoms and BED.
This study is a cross sectional observational study that was conducted on 75 ADHD patients and was conducted inthe Institute of Psychiatry, Faculty of Medicine/Ain Shams University during the period January 2020 – November 2020.
Following approval of the study protocol and receiving administrative approval and official permissions, informed consents were obtained from parents of patients to be included in the study following guarantee of data confidentiality. Socio-demographic and clinical data of the included patients were collected using a pre-designed sheet. The Arabic version of (K‐SADS‐PL) was used to confirm the diagnosis of ADHD, to determine its type and exclude other axis‐I comorbid psychiatric conditions. The Arabic version of Conner’s Parent Rating Scale-revised, long version was applied to detect the core symptoms of ADHD, detect its subtypes and assess severity. The Arabic version of the BES was used to assess the presence or absence of recurrent binge eating behaviors. And the Arabic version of BIS was used to describe common impulsive or non-impulsive behaviors and preferences.
The collected data was revised, coded, processed and analyzed using SPSS program for windows version 21 and the appropriate test of significance was conducted to compare between groups. A P value of < 0.05 was considered to be statistically significant, a P value of < 0.01 was considered to be highly statistically significant and a P value of < 0.001 was considered to be very highly statistically significant.
The main findings of this study were that 69.3% of the included patients were males, 16% of patients had a family history of ADHD and 86.7% of them were urban residents. As regards the types of ADHD, 56% of patients had combined type, 30.7% of them had inattentive type and 13.3% of them had hyperactive-impulsive type. 9.3% of the included patients had BED. However, BED was not significantly associated with Conners subscales or types of ADHD. No statistically significant association was found between BED and socio-demographic factors or clinical data factors, apart from BMI with ADHD patients with BED showing significantly higher BMI compared to those without BED. The severity of impulsivity was moderate in 50.7% of patients, mild in 44% and severe in 5.3%. For subtypes, 47.6% had motor type, 47.6% had attentional type and 4.8% had combined motor and attentional type. No significant association was found between BED and either severity or subtypes of impulsivity, although BIS scores tended to be higher in ADHD children with BED. Meanwhile, statistically significant association and positive correlation were found between binge eating and impulsivity scores.
It can be concluded from this study that BED is not uncommon in ADHD children as it is found in 9.3% of ADHD children in whom impulsivity can be proposed as a contributing factor for BED.
However, the results of the current study should be interpreted in view of its limitations. First of all, the included number of patients was relatively small. Second, the cross-sectional design of our study didn’t allow confirming causality in relationships and didn’t allow follow-up of included children to elucidate the association between ADHD symptoms during early childhood and development of BED in later childhood and adolescence. Third, the lack of a control group of children without ADHD for meaningful comparison. Fourth, other potential mediators on the ADHD-BED relationship, such as anxiety, depression and emotion regulation were not included in the current study.
The recommendations of this study for future researchers was to replicate this study on a wider scopeand in a longitudinal design addressing factors that were not included in this study and enrolling appropriate control groups, in order to gain insight and evaluate the association between ADHD and BED, as well as its clinical management when in comorbidity and therapeutic implications.