Perturbação de hiperatividade e défice de atenção e perturbações do comportamento alimentar: breve revisão
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v31.i2.24118Resumo
Introdução: A perturbação de hiperatividade e défice de atenção (PHDA) é uma doença comum do neurodesenvolvimento. Recentemente, a relação entre PHDA e perturbações do comportamento alimentar tem sido repetidamente equacionada. Ambas tendem a manifestar-se em idade precoce, podendo tornar-se condições crónicas e persistir na idade adulta.
Objetivos: Este estudo teve como objetivo elucidar a prevalência, sobreposição diagnóstica e semelhanças entre PHDA e perturbações do comportamento alimentar.
Métodos: Foi efetuada uma revisão bibliográfica da literatura na base de dados PubMed utilizando os termos “attention deficit hyperactive disorder”, “ADHD”, “eating disorders” e “ADHD and ED”.
Resultados: A maior parte dos estudos sugere uma prevalência de perturbações do comportamento alimentar em doentes com PHDA superior a 12%, existindo uma associação entre o diagnóstico de PHDA durante a infância e o desenvolvimento de perturbações do comportamento alimentar durante a adolescência. As perturbações do comportamento alimentar mais frequentemente associadas a PHDA são a perturbação de ingestão alimentar compulsiva e a bulimia nervosa. Por outro lado, a prevalência de PHDA varia entre 1.6─18% em indivíduos com perturbações do comportamento alimentar, sendo mais comum naqueles com anorexia nervosa do tipo purgativo e bulimia nervosa. Doentes com PHDA e perturbações do comportamento alimentar partilham determinadas características, como impulsividade, mecanismos de recompensa alterados, baixa auto-estima, défice de atenção e perturbação de funções executivas, que levam a um controlo motivacional disfuncional.
Discussão: É recomendada a investigação da sintomatologia de PHDA como parte integrante da avaliação das perturbações do comportamento alimentar. A associação entre ambas pode ser explicada pela combinação de mecanismos genéticos relacionados com vias dopaminérgicas ligadas ao processo de recompensa. A presença de sintomas de PHDA correlaciona-se com a gravidade da sintomatologia das perturbações do comportamento alimentar e é preditiva da gravidade da compulsão alimentar e sintomas bulímicos.
Conclusões: Existe uma sobreposição diagnóstica entre PHDA e perturbações do comportamento alimentar. São necessários estudos adicionais para esclarecer as implicações clínicas e terapêuticas da comorbilidade destas duas condições.
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