ADHS im Erwachsenenalter – Diagnostik und Therapie

Die ADHS ist eine neuronale Entwicklungsstörung des Gehirns, die im Kindesalter beginnt, meist bis ins Erwachsenenalter persistiert und dort zu Beeinträchtigungen führt. Psychische und körperliche Komorbiditäten können Diagnostik und Therapie erschweren. Der Artikel gibt einen Überblick über den aktuellen Wissensstand zur ADHS im Erwachsenenalter und zeigt, worauf bei der Diagnostik und der Therapie zu achten ist.

• Literatur

• 1 Thapar A, Cooper M. Attention deficit hyperactivity disorder. Lancet 2016; 387: 1240-1250
• 2 Sibley MH, Mitchell JT, Becker SP. Method of adult diagnosis influences estimated persistence of childhood ADHD: a systematic review of longitudinal studies. Lancet Psyc 2016; 3: 1157-1165
• 3 Fayyad J, Sampson NA, Hwang I. et al. The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys. Atten Defic Hyperact Disord 2017; 9: 47-65
• 4 Faraone SV, Perlis RH, Doyle AE. et al. Molecular genetics of attention-deficit/hyperactivity disorder. Biol Psychiatry 2005; 57: 1313-1323
• 5 Thapar A, Cooper M, Eyre O. et al. What have we learnt about the causes of ADHD?. J Child Psychol Psychiatry 2013; 54: 3-16
• 6 Doernberg E, Hollander E. Neurodevelopmental Disorders (ASD and ADHD): DSM-5, ICD-10, and ICD-11. CNS Spectr 2016; 21: 295-299
• 7 Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psy 2000; 157: 816-818
• 8 Larsson H, Anckarsater H, Rastam M. et al. Childhood attention-deficit hyperactivity disorder as an extreme of a continuous trait: a quantitative genetic study of 8500 twin pairs. J Child Psychol Psych 2012; 53: 73-80
• 9 Retz W, Stieglitz RD, Corbisiero S. et al. Emotional dysregulation in adult ADHD: What is the empirical evidence?. Expert Rev Neurother 2012; 12: 1241-1251
• 10 Jensen CM, Steinhausen HC. Comorbid mental disorders in children and adolescents with attention-deficit/hyperactivity disorder in a large nationwide study. Atten Defic Hyperact Disord 2015; 7: 27-38
• 11 Barbaresi WJ, Colligan RC, Weaver AL. et al. Mortality, ADHD, and psychosocial adversity in adults with childhood ADHD: a prospective study. Pediatrics 2013; 131: 637-644
• 12 Wender P. Attention-deficit hyperactivity disorder in adults. Oxford: Oxford University Press; 1995
• 13 Leibson CL, Katusic SK, Barbaresi WJ. et al. USe and costs of medical care for children and adolescents with and without attention-deficit/hyperactivity disorder. JAMA 2001; 285: 60-66
• 14 Erskine HE, Norman RE, Ferrari AJ. et al. Long-Term Outcomes of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder: A Systematic Review and Meta-Analysis. J Am Acad Child Adolesc Psyc 2016; 55: 841-850
• 15 Dalsgaard S, Ostergaard SD, Leckman JF. et al. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet 2015; 385: 2190-2196
• 16 Overmeyer S, Ebert D. Die hyperkinetische Störung im Jugend- und Erwachsenenalter. Dtsch Arztebl Int 1999; 96: 1275-1278
• 17 Fegert JM, Hauth I, Banaschewski T. et al. Übergang zwischen Jugend- und Erwachsenenalter: Herausforderungen für die Transitionspsychiatrie. Z Kinder Jugendpsy Psychother 2017; 45: 80-85
• 18 Bachmann CJ, Philipsen A, Hoffmann F. ADHS in Deutschland: Trends in Diagnose und medikamentöser Therapie. Dtsch Ärztebl Int 2017; 114: 141-148
• 19 National Institute for Health and Care Excellence. Attention deficit hyperactivity disorder: diagnosis and management of ADHD in children, young people and adults. National Clinical Practice Guideline No. 72. 2013 Im Internet: https://www.nice.org.uk/guidance/cg72 Zugriff am 17.08.2017
• 20 Ebert D, Krause J, Roth-Sackenheim C. ADHD in adulthood – guidelines based on expert consensus with DGPPN support. Nervenarzt 2003; 74: 939-946
• 21 Philipsen A, Jans T, Graf E. et al. Effects of Group Psychotherapy, Individual Counseling, Methylphenidate, and Placebo in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial. JAMA Psyc 2015; 72: 1199-1210
• 22 Moriyama TS, Polanczyk GV, Terzi FS. et al. Psychopharmacology and psychotherapy for the treatment of adults with ADHD – a systematic review of available meta-analysis. CNS Spectr 2013; 18: 296-306
• 23 Frodl T, Skokauskas N. Meta-analysis of structural MRI studies in children and adults with attention deficit hyperactivity disorder indicates treatment effects. Acta Psychiatr Scand 2012; 125: 114-126
• 24 Hoogman M, Bralten J, Hibar DP. et al. Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis. Lancet Psyc 2017; 4: 310-319
• 25 Asherson P, Bushe C, Saylor K. et al. Efficacy of atomoxetine in adults with attention deficit hyperactivity disorder: an integrated analysis of the complete database of multicenter placebo-controlled trials. J Psychopharmacol 2014; 28: 837-846
• 26 Diav-Citrin O, Shechtman S, Arnon J. et al. Methylphenidate in pregnancy: a multicenter, prospective, comparative, observational study. J Clin Psy 2016; 77: 1176-1181
• 27 Young Z, Moghaddam N, Tickle A. The Efficacy of Cognitive Behavioral Therapy for Adults With ADHD: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Atten Disord. 2016 DOI: 10.1177/1087054716664413
• 28 Young S, Khondoker M, Emilsson B. et al. Cognitive-behavioural therapy in medication-treated adults with attention-deficit/hyperactivity disorder and co-morbid psychopathology: a randomized controlled trial using multi-level analysis. Psychol Med 2015; 45: 2793-2804
• 29 Philipsen A, Richter H, Peters J. et al. Structured group psychotherapy in adults with attention deficit hyperactivity disorder: results of an open multicentre study. J Nerv Ment Dis 2007; 195: 1013-1019
• 30 Fleming AP, McMahon RJ, Moran LR. et al. Pilot randomized controlled trial of dialectical behavior therapy group skills training for ADHD among college students. J Atten Disord 2015; 19: 260-271