Die Erfassung von Aufmerksamkeit, Aktivität und Impulsivität bei Kindern und Jugendlichen mit einer Essstörung mittels QbTest, einem Infrarot Bewegungsanalysesystem

The aim of this study is to measure the three parameters attention, activity and impusiveness using the Qbtest (a computer based method) and to compare the results in different groups of patients. As a part of a larger project of three studies we examined a clinical population (n=502) of consecutive referrals at the department of Child and Adolescent Psychiatry and Psychotherapy at the Philipps-University of Marburg in the period of 06/01/2004 – 12/31/2005. 315 patients (63%) out of the total sample could be included. The special focus of this study was the group of patients with eating disorder (ED, n=41). The results of this group were compared with four additional patient groups (patients with a chronic schizophrenic disorder (n=22, F20-29), with mood disorders (n=20; F30-39), with neurotic stress and somatoform disorders (n=68; F40-48) and conduct disorders (n=31, F91.0-91.9). We compared the results of patients at the time of intake and of a discharge. In addition, we compared the results of patients with anorexia nervosa (an) with those suffering from bulimia nervosa (bn), and of patients with a secondary amenorrhea and those without this symptom. Furthermore, we tried to find out additional factors involved, such as IQ, age and BMI. Patients with ED achieved the best results and thus significantly differed from the schizophrenic patients (p=0.011) and patients with conduct disorder (p=0.000). We applied the d2-C-test in order to check the validity of the Qb-Test. When comparing the degree of impulsiveness patients with ED (F50) showed the lowest results and significantly differed from patients with conduct disorders revealing a distinctively impulsive behavior. The motor activity of patients with EDs was lowest, the results of patients with conduct disorders were highest (p=0.000). Comparing the results of the first and the second testing four out of five diagnostic groups improved their level of attention. Within the group of patients with EDs a divergence concerning the results of the two administered test could be found. The Qbtest showed a reduction of the attention level (p=0.402, effective power: 0.13), whereas the attention level in the d2-C-test resulted in an improvement with a high effect size (0.81). Furthermore, the intrasubject results of patients with EDs were better than those out of the second testing of the other four diagnostic groups. The results of motor activity are similar: the F50 group (without effect power) was more restless. Regarding impulsiveness group F50 improved. Only for patients with ED correlations between all test parameters could be found (activity – inattentiveness (p=0.006); activity – impulsiveness (p=0.032); impulsiveness – inattentiveness (p=0.02)). Applying analysis of covariance we tested, if the results of patients with AN differ from those with BN. There was no significant difference regarding impulsiveness. The examination of patients with a) a secondary amenorrhea and b) without this symptom did not show any significant differences. The IQ seems to be decisive for the Qb-test-results of patients with an ED. The GZ-F-degree of the d2-C-test showed no significant correlation with the IQ (except for group F91). Within group F50 only for two parameters of attention (Qb inattentiveness: p=0.00; Variation of reaction time: p=0.02) a correlation between age and test results could be obtained. The BMI in patients with ED was correlated with two other attention parameters and parameters of impulsiveness. In comparison with the four other groups, patients with EDs demonstrated the best capability in the areas of attention, impulsiveness and activity. We identified the IQ above all, and to a lesser degree the BMI and the age (in this order) as influential factors. Significant differences between the results of the two different eating disorders (anorexia and bulimia) as well as an influence of the secondary amenorrhea could not be found. We admit that this study is based upon a relatively small number of cases and that a standardization of the Qb-test for the age group tested is missing. Therefore results range merely on a descriptive level. Nevertheless we can recommend the clinical application of the Qb-test as an objective and simultaneous measurement of the three parameter attention, impulsiveness and motor activity.