注意力不足過動症症狀與暴食的關聯性

Association between Attention Defi cit Hyperactivity Disorder Symptoms and Bulimia among College Students

目的：注意力不足過動症的盛行率在飲食障礙症病人中較高，特別是在心因性暴食症 (bulimia nervosa) 患者。注意力不足過動症可能和暴食及嗜食 (binge eating) 有相關性，因以上 兩種疾病都有共通的臨床特色。本研究目的是在台灣研究族群中探討注意力不足過動症症狀 和暴食症狀間的相關性。方法：共招募 409 位就讀醫學大學的學生。我們使用中文注意力不 足過動症成人自我評量表 (ASRS)、暴食問卷表 (BITE)、病人健康狀況問卷 -9(PHQ-9)、及家 庭功能量表 (Family APGAR scale) 來評估受試者。使用複迴歸分析來調查暴食及嗜食症狀和 年齡、性別、憂鬱症狀、家族支持及注意力不足過動症之間的關聯性。結果：大學學生以量 表篩檢符合暴食者比起不符合者有較高的憂鬱、過動／衝動分數。中文注意力不足過動症成 人自我評量表的注意力不足分數和暴食問卷表症狀分數、嚴重度分數及總分有中度相關。後 續複迴歸分析發現憂鬱症狀、過動／衝動分數仍和暴食症症狀、嚴重度及量表總分有關。結 論：本研究發現注意力不足過動症的過動／衝動及憂鬱和暴食及嗜食行為有相關性。在注意 力不足過動症病人中評估暴食症狀可能是需要的。

Background: Attention defi cit hyperactivity disorder (ADHD) prevalence is increasing in eating disorder patients, especially in bulimia nervosa. ADHD may be associated with bulimia and binge eating because both disorders share certain clinical features. Objective: The purpose of the present study was to explore the association between ADHD symptoms and bulimia symptoms in Taiwan. Methods: We recruited 409 college students from a medical school. We assessed the participants with Adult ADHD Self-Report Scale Chinese Version (ASRS), the Bulimic Investigatory Test, Edinburgh (BITE), Chinese version of the Patient Health Questionnaire (PHQ-9), and the Family APGAR scale. Multiple regression was performed to investigate the relationship between the bulimic and binge eating symptoms with the age, gender, depression symptoms, family support and ADHD symptoms. Results: College students screened positive with bulimia had signifi cantly higher depression, hyperactivity and impulsivity symptoms than those screened negative (p < 0.05). The ASRS inattention and hyperactivity/impulsivity scores were modestly correlated with BITE symptoms, severity and total scores. The result of subsequent linear regression showed that hyperactivity/impulsivity and depression symptoms were constantly associated with BITE symptoms, severity and total scores. Conclusions: The present study showed that hyperactivity, impulsivity and depression symptoms are associated with binge eating behaviors. Assessment for eating disorder in ADHD patients may be indicated.