This cross-sectional study assessed ADHD prevalence (via structured DIVA-5 interview) and its associations with depressive symptoms (BDI-II), anxiety (BAI), and impulsivity (BIS-11) in 70 adults with obesity undergoing preoperative psychological evaluation for metabolic and bariatric surgery at a single academic center (May 2024–June 2025).
ADHD was diagnosed in 18.6% (13/70) of candidates. Participants with ADHD had markedly higher depression scores (BDI-II: 18.16 vs. 8.19, p<0.001), anxiety scores (BAI: 26.92 vs. 15.51, p=0.004), and impulsivity (BIS-11: 42.69 vs. 34.21, p=0.021). In multivariable regression, female sex, ADHD diagnosis, and impulsivity independently predicted depressive severity (R²=0.418); female sex and ADHD diagnosis independently predicted anxiety severity (R²=0.209).
- Cross-sectional design prevents causal inference. - Small sample (n=70) from a single center limits generalizability. - Sample was predominantly female (84%), restricting conclusions about sex-specific effects.
Screen bariatric surgery candidates for ADHD and impulsivity during preoperative psychological evaluation — nearly 1 in 5 may have ADHD, which independently drives higher depression and anxiety burden. Patients flagged on attentional or impulse-control measures should receive enhanced psychological support before surgery.
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