Comorbilidad de TCA, obesidad y TDAH

20 de enero de 2021 |
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Comorbilidad de TCA, obesidad y TDAH


El trastorno por déficit de atención con o sin hiperactividad (TDAH) se ha descubierto en los últimos años como una comorbilidad relevante de la obesidad y los trastornos de la conducta alimentaria (TCA). Una comorbilidad que los clínicos debemos conocer para tener en cuenta y tratar adecuadamente para mejorar la calidad de vida y el pronóstico de nuestros pacientes.

El TDAH es un diagnóstico común en la infancia y adolescencia con comorbilidades frecuentes (Quinn, 2008). La comorbilidad es la norma más que la excepción. Los TCA y la obesidad, de acuerdo con los estudios recientes, pueden representar una de ellas (Mikami et al, 2008). Rigurosos estudios refieren la relación del TDAH con una mayor predisposición a la obesidad. Con mayores valores de signos de sobrenutrición, como el ïndice de Msasa Corporal o IMC o Quetelet (Waring y Lapane, 2008) o  un mayor valor de grasa (Ptácek et al, 2009). Puede ser causada por la impulsividad y costumbres alimentarias específicas de los pacientes con TDAH, su estilo de vida (Ptácek et al, 2010).

El TDAH en la infancia está fuertemente asociado con el riesgo para un amplio rango de trastornos psiquiátricos durante la adolescencia (con una odds ratio (OR) de 10,6) en un estudio de cohorte con 5718 niños nacidos entre 1976-1982 que permanecen en Rochester seguidos hasta los 19 años. Se identificaron 379 casos de TDAH incidente y se aparearon por edad y sexo con 758 controles no TDAH. Se calculó los hazard ratios (HR) usando modelos Cox (análisis de supervivencia). La HR fue de 5,68 para los TCA (Yoshimasu et al, 2012, Clínica Mayo).

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