Clinical Study On The Severity Of Attention Deficit Hyperactivity Disorder And Obesity And Its Intervention In School-age Children

Obejective:To explore the correlation between the severity of attention deficit hyperactivity disorder（ADHD）symptoms and obesity in school-age children,and the influence of reasonable diet intervention on the clinical symptoms of ADHD with obesity.Methods:Children with ADHD who were treated or hospitalized in children’s and adolescents’outpatient department of Qingdao Mental Health Center from June 2020 to June 2021were selected as the research object.According to the BMI reference norm for screening overweight and obesity in Chinese children and adolescents,60 patients with body mass index-percentil（BMI-P）≥P₉₅were randomly selected as ADHD with obesity group,60patients with BMI-P in P₅-P₈₅as ADHD group.At the same time,60 healthy children from a primary school in Qingdao were selected as the healthy control group.Self-made basic demographic characteristics questionnaire and Conners Parent Symptom Questionnaire（PSQ）were used for evaluation.Meanwhile,the body mass index was calculated,and the scores of the three groups of children were compared to analyze the correlation between the severity of ADHD symptoms and obesity.To further understand the influence of losing weight on ADHD symptoms,the ADHD with obesity group was randomly divided into diet intervention group and non-diet intervention group,with 30cases in each group.The diet intervention group was given a reasonable diet intervention for 12 weeks,while the non-diet intervention group was only given enough medication.The height and weight were measured at baseline and 12 weeks,and PSQ was assessed.The scale scores and BMI-P changes of the two groups were compared before and after intervention,and the influence of reasonable diet on ADHD symptoms was analyzed.Results:1.The total scores of BMI-P,PSQ,conduct problems,impulsive-hyperactivity index,hyperactivity index and anxiety factor scores were higher in ADHD with obesity group than in ADHD group（all P<0.05）.There was no significant difference in learning factor and psychosomatic disorder score between ADHD with obesity group and ADHD group（P>0.05）.2.The correlation test between BMI-P and PSQ showed that the scores of conduct problem and anxiety factors of ADHD children with obesity were positively correlated with BMI-P（r=0.287,0.319,all P<0.05）.3.The results of binary Logistic regression analysis showed that conduct problem（OR=2.703,95%CI:1.735～4.213）and anxiety（OR=4.114,95%CI:2.107～8.003）of ADHD children were independent risk factors for obesity（all P<0.05）.4.After the intervention,BMI-P（t=9.241,P<0.05）and total score of PSQ（t=13.331,P<0.05）were decreased in the diet intervention group,and the conduct problems（t=23.291,P<0.05）,impulsivity-hyperactivity（t=6.915,P<0.05）,hyperactivity index（t=6.915,P<0.05）and anxiety factor（t=4.261,P<0.05）scores were decreased significantly,suggesting that the weight of the diet intervention group decreased and ADHD symptoms improved after the diet intervention,especially the conduct problems,impulse-hyperactivity and anxiety symptoms.5.After the intervention,BMI-P（t=5.463,P<0.05）and total score of PSQ（t=6.281,P<0.05）were decreased in the diet intervention group,among which the conduct problems（t=6.126,P<0.05）,hyperactivity index（t=5.544,P<0.05）were found decreased significantly,suggesting that the weight of non-dietary intervention group decreased,and ADHD symptoms improved,especially the conduct problems and ADHD symptoms.6.Compared with the diet intervention group,the BMI-P（t=2.477,P=0.016）and PSQ scores（t=8.786,P<0.05）of the non-diet intervention group were higher than those of the diet intervention group,among which the scores of conduct problems（t=12.506,P<0.05）,impulse-hyperactivity（t=4.726,P<0.05）and anxiety factors（t=2.467,P=0.017）were higher,suggesting that the diet intervention group lost more weight than the non-dietary intervention group while ADHD symptoms improved more,especially the conduct problems,impulse-hyperactivity and anxiety problems.Conclusions:1.Anxiety symptoms and the severity of conduct problems in ADHD children are related to obesity.The higher the weight of children,the more serious the anxiety symptoms and conduct problems are.2.Reasonable diet combined with Tomoxetine can effectively improve the clinical symptoms of ADHD children with obesity compared with Tomoxetine alone.