Evaluation of relationships between eating habits, anxiety levels and serum cortisol level and body mass index in children diagnosed with attention deficit and hyperactivity disorder and attention deficit and hyperactivity disorder with comorbid slow cognitive tempo

Objective: The aim of this study is to describe the clinic of cases diagnosed with Attention Deficit and Hyperactivity Disorder (ADHD) and Sluggish Cognitive Tempo (SCT) comorbid with Attention Deficit and Hyperactivity Disorder, and to show the differences between these two groups by examining their eating behaviors. It also aims to evaluate the relationship between ADHD sub-presentations and eating behaviors of these two groups and their anxiety levels. In addition, it was aimed to investigate the relationships between Body Mass Index percentiles (BMI-p) and blood cortisol level measurements of both groups and eating behaviors, anxiety levels and ADHD symptoms. Materials and Methods: According to the diagnostic criteria of DSM-5, those who applied to Düzce University Faculty of Medicine Child and Adolescent Psychiatry Polyclinic; 45 children diagnosed with ADHD only and 46 children diagnosed with ADHD and SCT were included in the study. Among these children, those who met the inclusion criteria were matched in terms of age and gender and included in the study. Information about the study was provided and written consent was obtained. Participants in both groups and their parents were administered sociodemographic data form, Barkley Child Attention Questionnaire, Child Nutrition Behavior Questionnaire, The Screen for Child Anxiety and Related Disorders (SCARED), Turgay DSM-IV Based Assessment and Screening Scale for Behavior Disorders in Children and Adolescents was applied. Additionally, serum Cortisol levels and BMI measurements were taken for the children participating in the study. Results: With the information obtained from sociodemographic data; It was found that the number of meals in the ADHD+SCT group was statistically significantly higher than the ADHD group. The ADHD+SCT group's average physical activities at school, at home and weekly were found to be lower. In the ADHD group, the rate of high physical activity in more than one environment was found to be significantly higher than in the ADHD+SCT group. When looking at comparisons between groups in terms of dominant appearances; While inattention predominance rates were significantly higher in the ADHD+SCT group, hyperactive/impulsive predominance rates were significantly lower. The total score and subscale scores of the SCARED scale measured in the ADHD+SCT group were found to be significantly higher. In the ADHD+SCT and ADHD groups, a significant positive correlation was detected between the SCARED subscales and the ÇBDA subscale scores. Positive relationships were detected between BMI-p value and Food Enjoyment, Food Approach Total, DB Total Score scores in the ADHD+AD group. In the ADHD group; A positive correlation was detected between BMI-p value and Food Enthusiasm, Emotional Overeating, Food Enjoyment and Drinking Passion scores. In the ADHD comorbid SCT group, no significant relationship was detected between serum cortisol levels and the scales examined in the study and the subscale scores of these scales. However, in the ADHD group, a positive significant relationship was found between serum cortisol levels and separation anxiety subscale score. Conclusions: In our study, it was observed that eating behaviors and anxiety levels in cases with ADHD and ADHD+SCT can have positive and negative effects on each other, and that this varies between groups depending on the predominant appearance of ADHD. Additionally, relationships between BMI-p and eating behaviors were found in these groups. Studies with larger samples are required to better explain the relationships between BMI-p and blood cortisol level measurements and eating behaviors, anxiety levels and ADHD symptoms. The results of our study will contribute to making inferences about social and medical measures that can be taken for follow-up and protection purposes after diagnosis of these cases. KEY WORDS: ADHD, Anxiety Disorder, BMI, Cortisol, Feeding Behavior, SCT