The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis

ABSTRACT Objective There has been interest in whether people with Attention‐Deficit/Hyperactivity Disorder (ADHD) are at higher risk of developing an Eating Disorder (ED). The aim of this study was estimate the size of this association with a meta‐analysis of studies. Methods We retrieved studies following PRISMA guidelines from a broad range of databases. Results Twelve studies fitted our primary aim in investigating ED in ADHD populations (ADHD = 4,013/Controls = 29,404), and five exploring ADHD in ED populations (ED = 1,044/Controls = 11,292). The pooled odds ratio of diagnosing any ED in ADHD was increased significantly, 3.82 (95% CI:2.34–6.24). A similar level of risk was found across all ED syndromes [Anorexia Nervosa = 4.28 (95% CI:2.24–8.16); Bulimia Nervosa = 5.71 (95% CI: 3.56–9.16) and Binge Eating Disorder = 4.13 (95% CI:3–5.67)]. The risk was significantly higher if ADHD was diagnosed using a clinical interview [5.89 (95% CI:4.32–8.04)] rather than a self‐report instrument [2.23 (95% CI:1.23–4.03)]. The pooled odds ratio of diagnosing ADHD in participants with ED was significantly increased, 2.57 (95% CI:1.30–5.11). Subgroup analysis of cohorts with binge eating only yielded a risk of 5.77 (95% CI:2.35–14.18). None of the variables examined in meta‐regression procedures explained the variance in effect size between studies. Discussion People with ADHD have a higher risk of comorbidity with an ED and people with an ED also have higher levels of comorbidity with ADHD. Future studies should address if patients with this comorbidity have a different prognosis, course and treatment response when compared to patients with either disorder alone. Resumen Objetivo Ha habido interés en saber si la gente con Trastorno por Déficit de Atención e Hiperactividad (TDAH) están en mayor riesgo de desarrollar un Trastorno de la Conducta Alimentaria (TCA). El objetivo de este estudio fue estimar el tamaño de esta asociación con un meta‐análisis de los estudios. Métodos: Recuperamos estudios de una amplia gama base de datos, que siguen los lineamientos PRISMA. Resultados: Doce estudios encajaron con nuestro objetivo primario de investigar los TCA en poblaciones con TDAH (TDAH = 4,013/Controles = 29,404), y 5 exploraron TDAH en poblaciones con TCA (TCA = 1,044/Controles = 11,292). El odds ratio (OR) agrupado de diagnosticar cualquier TCA en el TDAH se incrementó significativamente, 3.82 (95% CI:2.34–6.24). Un nivel de riesgo similar fue encontrado en todos los sín