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Examining the relationship between Attention-Deficit/Hyperactivity Disorder and overweight in children and adolescents

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Abstract

Although a higher prevalence of overweight/obesity was reported in clinical samples of patients with Attention-Deficit/Hyperactivity Disorder (ADHD), an association between overweight and ADHD has yet not been established in the general population in childhood. As both disorders are common and significantly affect psychosocial functioning, we investigated the prevalence of ADHD in overweight/obese youth and vice versa. In a cross-sectional nationally representative and community based survey 2,863 parents and their children aged 11–17 years rated symptoms on the Diagnostic and Statistical Manual of Mental Disorders-based German ADHD Rating scale. Weight and height were assessed by professionals. Body mass index was categorized according to national age and sex specific reference values. Overall, 4.2% of the respondents met criteria for ADHD. The prevalence of ADHD was significantly higher for overweight/obese (7%) than for normal weight (3.5%) and underweight (4.9%) children. In a logistic regression analysis controlling for age, gender, and socio-economic status, overweight/obese children were twice as likely to have an ADHD diagnosis (OR = 2.0). Vice versa, adjusting for all covariates, children with ADHD had an OR of 1.9 for overweight/obesity status. For all weight-status groups, children with ADHD more frequently reported eating problems as compared to their non-clinical counterparts. Overweight/obese respondents with ADHD displayed the highest level of health services utilization. A clinician should be aware of the significant risk for a child with ADHD to become overweight and for an overweight child to have ADHD. Longitudinal studies are needed to better understand the mechanisms underlying the association between ADHD and overweight/obesity.

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Acknowledgments

The authors would like to thank all coworkers who carried out the field work of the KiGGS and the BELLA study. The authors especially thank all children, adolescents and their parents who participated in the study. The authors Dr. Ravens-Sieberer and Dr. Erhart confirm that they have full access to all the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Conflict of interest

The BELLA study module of the German Health Interview and Examination Survey for Children and adolescents (KiGGS) was financed by a Grant of the German Research Foundation. The KiGGS survey was financed and carried out on the request of the German Ministry of Health. The writing and submission of the manuscript was not contingent on the approval or censorship of the German Research Foundation or the German Ministry of Health. There was no direct financial support for the preparation of the manuscript. Dr. Herpertz-Dahlmann is a consultant to Eli Lilly and has received industry funding from AstraZeneca, Eli Lilly, Novartis and Janssen Cilag. All other authors declare no conflict of interest.

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Authors and Affiliations

  1. University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Michael Erhart, Nora Wille & Barbara Sawitzky-Rose

  2. University Hospital Aachen, Aachen, Germany

    Beate Herpertz-Dahlmann

  3. Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany

    Michael Erhart

  4. Robert Koch-Institute, Berlin, Germany

    Heike Hölling

  5. Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics , University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    Ulrike Ravens-Sieberer

Authors
  1. Michael Erhart
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  2. Beate Herpertz-Dahlmann
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  3. Nora Wille
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  4. Barbara Sawitzky-Rose
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  5. Heike Hölling
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  6. Ulrike Ravens-Sieberer
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Correspondence to Ulrike Ravens-Sieberer.

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Erhart, M., Herpertz-Dahlmann, B., Wille, N. et al. Examining the relationship between Attention-Deficit/Hyperactivity Disorder and overweight in children and adolescents. Eur Child Adolesc Psychiatry 21, 39–49 (2012). https://doi.org/10.1007/s00787-011-0230-0

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  • DOI: https://doi.org/10.1007/s00787-011-0230-0

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