Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Ergenlerde Yeme Davranışı ve Yaşam Kalitesinin İncelenmesi

Öz

Amaç: Çalışmamızın amacı, Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) olan ergenlerde yeme davranışı ve yaşam kalitesini araştırmaktır. Gereç ve Yöntemler: Çalışmaya DEHB tanısı alan 100 ergen olgu ve yaş, cinsiyet açısından olgu grubu ile eşleştirilmiş 100 sağlıklı ergen dahil edilmiştir. “Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi” (ÇDŞG) kullanılarak klinik görüşmeler yapılmış, Hollanda Yeme Davranışı Anketi (HYDA), Çocuklar İçin Yaşam Kalitesi Ölçeği (ÇİYKÖ) özbildirim ve ebeveyn bildirimleri, Conners Anne-Baba Derecelendirme Ölçeği (CADÖ) uygulanmıştır. Bulgular: DEHB grubunda kontrol grubuna göre, ÇİYKÖ öz bildirim ve anne-baba bildirimlerinde tüm ölçek puanlarında DEHB grubunda anlamlı düşük (p<0,05), duygusal ve dışsal yeme alt ölçek puanları istatistiksel olarak anlamlı yüksek tespit edilmiştir (sırasıyla, p=0,006, p=0,001). DEHB grubunda duygusal yeme puanları ile CADÖ dikkat eksikliği (p=0,038), hiperaktivite (p=0,001), karşıt olma karşı gelme (p=0,002) alt ölçek puanları arasında ve dışsal yeme puanı ile hiperaktivite puanı arasında pozitif anlamlı korelasyonlar bulunmuştur (p=0,024). ÇİYKÖ öz bildirim puanlarından duygusal işlevsellik (p=0,05), psikososyal sağlık toplam puanı (p=0,036) ile duygusal yeme alt ölçek puanı arasında anlamlı negatif korelasyon bulunmuştur. ÇİYKÖ yaşam kalitesi anne baba bildirimlerinde ise sadece psikososyal sağlık toplam puanı (p=0,034) ile duygusal yeme alt ölçek puanı arasında anlamlı negatif korelasyon bulunmuştur. Sonuç: Çalışmamızın sonuçları DEHB takip ve tedavisinde, DEHB belirtileri ile birlikte yeme tutumlarının ve yaşam kalitesinin de değerlendirmesinin koruyucu ruh sağlığı kapsamında önem taşıdığına işaret etmektedir.

Anahtar Kelimeler

• DEHB
• duygusal yeme
• dışsal yeme
• yaşam kalitesi

Eating Behaviours and Quality of Life in Adolescents with Attention Deficit Hyperactivity Disorder

Öz

Aim: Our study aims to investigate eating behaviour and quality of life in adolescents with Attention Deficit Hyperactivity Disorder (ADHD). Material and Methods: This study included 100 adolescents diagnosed with ADHD and age-gender matched 100 healthy adolescents. Clinical interview was conducted using “Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS)” and Dutch Eating Behavior Questionnaire (DEBQ), Pediatric Quality of Life Scale (PedsQL) self and parent reports, Conners Parent Rating Scale (CPRS) were administered. Results: In ADHD group compared to control group, all subscales were found to be significantly lower in PedsQL self-report and parent-reports (p<0.05), while emotional and external eating subscale scores were found to be statistically significantly higher (p = 0.006, p = 0.001, respectively). In the ADHD group, positive significant correlations were found between emotional eating subscale scores and CPRS inattention (p = 0.038), hyperactivity (p = 0.001), and oppositional behaviour (p = 0.002), and also between the external eating subscale and hyperactivity score (p = 0.024). Regarding self reports of quality of life, significant negative correlations were found between emotional eating subscale score and both emotional functionality (p = 0.05) and psychosocial health total score (p = 0.036). In PedsQL parent reporting, a significant negative correlation was found only between psychosocial health total score (p = 0.034) and emotional eating subscale score. Conclusion: The results of our study indicate the importance of evaluating eating behaviours and quality of life in follow up and treatment of ADHD in terms of preventive strategies for mental health.

Anahtar Kelimeler

• ADHD
• emotional eating
• external eating
• quality of life

Kaynakça

1. 1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). 5th ed. Arlington: American Psychiatric Association; 2013.
2. 2. Gnanavel S, Sharma P, Kaushal P, Hussain S. Attention deficit hyperactivity disorder and comorbidity: A review of literature. World J Clin Cases. 2019; 7(17): 2420–26.
3. 3. Johnson F, Pratt M, Wardle J. Dietary restraint and self-regulation in eating behavior. Int J Obes (Lond). 2012; 36(5): 665-74.
4. 4. Wu S, Cai T, Luo X. Validation of the Dutch eating behavior questionnaire (DEBQ) in a sample of Chinese adolescents. Psychology, health & medicine. 2017; 22(3): 282-88.
5. 5. Telch CF, Agras WS, Linehan, MM. Dialectical behavior therapy for binge eating disorder. Journal of Consulting and Clinical Psychology. 2001; 69(6): 1061–65.
6. 6. Snoek HM, Engels RC, van Strien T, Otten R. Emotional, external and restrained eating behaviour and BMI trajectories in adolescence. Appetite. 2013; 67: 81-7.
7. 7. Hou R, Mogg K, Bradley BP, Moss-Morris R, Peveler R, Roefs A. External eating, impulsivity and attentional bias to food cues. Appetite. 2011; 56(2): 424-7.
8. 8. Elfhag K, Morey LC. Personality traits and eating behavior in the obese. Poorself-control in emotional and external eating but personality assets in restrained eating. Eat Behav. 2008; 9(3): 285-93.

9. 9. Tanofsky‐ Kraff M, Engel S, Yanovsk, JA, Pine DS, Nelson EE. Pediatric disinhibited eating: toward a research domain criteria framework. International Journal of Eating Disorders. 2013; 46(5): 451-55.
10. 10. Curtin C, Pagoto SL, Mick E. The association between ADHD and eating disorders/pathology in adolescents: a systematic review. The Open Epidemiology Journal. 2013; 3(4):193-202.
11. 11. Goldschmidt AB, Hipwell AE, Stepp SD, McTigue KM, Keenan K. Weight gain, executive functioning, and eating behaviors among girls. Pediatrics. 2015;136(4):e856–e863.
12. 12. Seitz J, Kahraman-Lanzerath B, Legenbauer T, Sarrar L, Herpertz S, Salbach-Andrae H, et al. The role of impulsivity, inattention and comorbid ADHD in patients with bulimia nervosa. PLoS One. 2013; 8(5): e63891.
13. 13. Cortese S, Isnard P, Frelut ML, Michel G, Quantin L, Guedeney A, et al. Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents. Int J Obes (Lond). 2007; 31(2): 340-46.
14. 14. Leidy NK, Rich M, Geneste B. Recomendations for evaluating the validity of life claims for labeling and promotion. Value Health. 1999; 2: 113–27.
15. 15. Biederman J, Monuteaux M, Mick E, Spencer T, Wilens T, Silva J, et al. Young adult outcome of attention deficit hyperactivity disorder: a controlled 10 year prospective follow-up study. Psychological Medicine. 2006; 36(2): 167–79.
16. 16. Danckaerts M, Sonuga-Barke EJ, Banaschewski T, Buitelaar J, Döpfner M, Hollis C, et al. The quality of life of children with attention deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry. 2010; 19(2): 83–105.
17. 17. Ágh T, Kovács G, Supina D, Pawaskar M, Herman BK, Vokó Z, et al. A systematic review of the health-related quality of life and economic burdens of anorexia nervosa, bulimia nervosa, and binge eating disorder. Eat Weight Disord. 2016; 21(3): 353-64.
18. 18. Yıldız Ö, Cakın Memik N, Agaoglu B. Dikkat eksikliği hiperaktivite bozukluğu tanılı çocuklarda yaşam kalitesi: Kesitsel bir çalışma. Nöropsikiyatri Arşivi. 2010; 47:314-18.
19. 19. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997; 36(7): 980-8.
20. 20. Gökler B, Ünal F, Pehlivantürk B, Kültür EÇ, Akdemir D, Taner Y. Reliability and validity of schedule for affective disorders and schizophrenia for school age children-present and lifetime version-Turkish version (K-SADS-PL-T). Çocuk ve Gençlik Ruh Sağlığı Dergisi/Turkish Journal of Child and Adolescent Mental Health. 2004; 11(3):109-116.
21. 21. Conners CK, Sitarenios G, Parker JD, Epstein JN. The revised Conners' Parent Rating Scale (CPRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol. 1998; 26(4):257-68.
22. 22. Kaner S, Büyüköztürk Ş, İşeri E. Conners parent rating scale-revised short: Turkish standardization study. Noro Psikiyatr Ars. 2013; 50:100-109.
23. 23. Van Strein T, Frijters J, Bergers G, Defares P. The Dutch eating behaviour questionnaire (DEBQ) for assesment of restrained, emotional and external eating behaviour. International Journal of Eating Disorder. 1986; 5: 295-315.
24. 24. Bozan N. Hollanda yeme davranışı (HYDA) anketinin Türk üniversite öğrencilerinde geçerlilik ve güvenirliğinin sınanması. Yüksek lisans tezi, Başkent Üniversitesi, Sağlık Bilimleri Enstitüsü, Beslenme ve Diyetetik Bölümü, Ankara, 2009.
25. 25. Varni JW, Seid M, Rode CA. The PedsQL: measurement model for the pediatric quality of life inventory. Med Care. 1999 Feb;37(2):126-39.
26. 26. Memik NÇ, Ağaoğlu B, Coşkun A, Üneri ÖŞ, Karakaya I. Çocuklar için yaşam kalitesi ölçeğinin 13-18 yaş ergen formunun geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi. 2007; 18(4), 353-363.
27. 27. Davis C, Levitan RD, Smith M, Tweed S, Curtis C. Associations among overeating, overweight, and attention deficit/hyperactivity disorder: a structural equation modelling approach. Eat Behav. 2006; 7(3): 266-74.
28. 28. Tong L, Shi H, Li X. Associations among ADHD, abnormal eating and overweight in a nonclinical sample of Asian children. Sci Rep. 2017; 7(1): 1-8.
29. 29. Bleck J, DeBate RD. Exploring the co-morbidity of attention-deficit/hyperactivity disorder with eating disorders and disordered eating behaviors in a nationally representative community-based sample. Eat Behav. 2013; 14(3): 390-93.
30. 30. Patte KA, Davis CA, Levitan RD, Kaplan AS, Carter-Major J, Kennedy JL. A behavioral genetic model of the mechanisms underlying the link between obesity and symptoms of ADHD. Journal of Attention Disorders. 2020; 24(10): 1425-36.
31. 31. Zeman J, Cassano M, Perry-Parrish C, Stegall S. Emotion regulation in children and adolescents. Journal of Developmental & Behavioral Pediatrics. 2006; 27(2): 155-68.
32. 32. Reinblatt SP, Mahone EM, Tanofsky-Kraff M, Lee-Winn AE, Yenokyan G, Leoutsakos JM, et al. Pediatric loss of control eating syndrome: Association with attention-deficit/hyperactivity disorder and impulsivity. Int J Eat Disord. 2015; 48(6): 580-8
33. 33. Atalayer D. Link between ımpulsivity and overeating:psychological and neurobiological perspectives. Current Approaches in Psychiatry. 2018; 10(2): 131-47
34. 34. Erhart M, Herpertz-Dahlmann B, Wille N, Sawitzky-Rose B, Hölling H, Ravens-Sieberer U. Examining the relationship between attention-deficit/hyperactivity disorder and overweight in children and adolescents. Eur Child Adolesc Psychiatry. 2012; 21(1): 39-49.
35. 35. Sonuga-Barke EJ. Causal models of attention-deficit/hyperactivity disorder: from common simple deficits to multiple developmental pathways. Biological psychiatry. 2005; 57(11): 1231–38.
36. 36. Campbell BC, Eisenberg D. Obesity, attention deficithyperactivity disorder and the dopaminergic reward system. Collegium Antropol. 2007; 31(1): 33–8.
37. 37. Görgü E. Dikkat eksikliği ve hiperaktivitesi olan çocuklar ile normal gelişim gösteren çocukların yeme davranışlarının karşılaştırılması. Eğitim ve Bilim. 2020; 45: 425-41.
38. 38. Leventakou V, Micali N, Georgiou V, Sarri K, Koutra K, Koinaki S, et al. Is there an association between eating behaviour and attention‐deficit/hyperactivity disorder symptoms in preschool children? Journal of Child. Psychology and Psychiatry. 2016; 57(6): 676–84.
39. 39. Pongwilairat K, Louthrenoo O, Charnsil C, Witoonchart C. Quality of life of children with attention-deficit/hyper activity disorder. J Med Assoc Thai. 2005; 88(8): 1062-66.
40. 40. Yurteri N, Akay AP, Ellidokuz H. DEHB’li çocuklarda sağlıkla ilgili yaşam kalitesinin tip 1 diyabet ve sağlıklı kontrol gruplarıyla karşılaştırılarak değerlendirilmesi. Anadolu Psikiyatri Dergisi. 2019; 20(5): 539 - 47.
41. 41. Jenkins PE, Hoste RR, Meyer C, Blissett JM. Eating disorders and quality of life: a review of the literature. Clin Psychol Rev. 2011; 31(1): 113-21.
42. 42. Herpertz-Dahlmann B, Wille N, Hölling H, Vloet TD, Ravens-Sieberer U, BELLA Study Group. Disordered eating behaviour and attitudes, associated psychopathology and health-related quality of life: Results of the BELLA study. Eur Child Adolesc Psychiatry. 2008; 17: 82-91.
43. 43. Stice E, Marti CN, Shaw H, Jaconis M. An 8-year longitudinal study of the natural history of threshold, subthreshold, and partial eating disorders from a community sample of adolescents. J Abnorm Psychol. 2009; 118(3): 587-97.