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ADHD in a patient with eating disorder. Case report

Published online by Cambridge University Press:  01 September 2022

P. Del Sol Calderón*
Affiliation:
Hospital Universitario Puerta de Hierro, Psiquiatría Infanto-juvenil, Madrid, Spain
A. Izquierdo De La Puente
Affiliation:
HOSPITAL UNIVERSITARIO PUERTA DE HIERRO MAJADAHONDA, Psychiatry, MADRID, Spain
M. Garcia Moreno
Affiliation:
HOSPITAL UNIVERSITARIO PUERTA DE HIERRO MAJADAHONDA, Psychiatry, MADRID, Spain
R. Paricio Del Castillo
Affiliation:
Hospital Universitario Puerta de Hierro, Psiquiatría Infanto-juvenil, Madrid, Spain
L. Mallol Castaño
Affiliation:
Hospital Universitario Puerta de Hierro, Psiquiatría Infanto-juvenil, Madrid, Spain
*
*Corresponding author.

Abstract

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Introduction

15-year-old female referred to outpatient unit after COVID lockdown for binge eating and purging with depressive symptoms and anxiety.

Objectives

To show the importance of a correct diagnosis in an impulsive patient with eating disorder

Methods

case report and literature review

Results

The patient presents emotional instability with interpersonal difficulties with high fear of rejection. She suffered from fear of gaining weight and desires to lose weight with rejection of her body image. Fluoxetine and lorazepam are started together with low doses of olanzapine. During the follow up she presented a worsening of mood, onset of self-injuries and an episode of suicidal attempt. A biographical examination was performed, expressing a feeling of academic failure with difficulty concentrating and performing simple tasks. As a child she is described as impulsive, with frequent arguments with classmates. CPT III was performed with a high probability of ADHD. Treatment was started with lisdexamfetamine up to 50 mg with good tolerance. From the beginning of the treatment the patient expressed a feeling of improvement in the control of emotions as well as in the management of her impulsivity. There was an improvement in her academic performance with a decrease in self-injury episodes. The patient was able to express improvement in the sense of incapacity she felt.

Conclusions

This case shows how marked emotional dysregulation and impulsive symptoms improves after diagnosis and subsequent treatment of ADHD, also improving eating symptoms. ADHD is present in eating disorders, especially in those with impulse dyscontrol such as binge eating disorder or bulimia nervosa.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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