ADHS und Sucht im Erwachsenenalter

M. Ridinger

doi:10.1055/s-0037-1616449

Nervenheilkunde, Table of Contents

Nervenheilkunde 2016; 35(11): 764-769
DOI: 10.1055/s-0037-1616449

Sucht

Schattauer GmbH

ADHS und Sucht im Erwachsenenalter

ADHD and addictive behaviour in adulthood

M. Ridinger

¹Psychiatrische Dienste Aargau (PDAG) Zentrum für Suchtpsychiatrie und -psychotherapie, Brugg AG; Schweiz

²Klinik und Poliklinik für Psychiatrie und Psychotherapie der Universität Regensburg, Regensburg

› Author Affiliations

Abstract

Zusammenfassung

Gegenstand und Ziel: Übersichtsartikel zur Komorbidität von ADHS und Sucht im Erwachsenenalter. Die Prävalenz des kindlichen ADHS beträgt 5% und ist mit einem erhöhten Suchtrisiko verbunden, was zu ADHS-Prävalenzraten bis zu 23,1% bei erwachsenen Substanzabhängigen führt. ADHS führt ab der Kindheit zu Beeinträchtigungen im Entwicklungsverlauf. Als Haupthypothese für die Suchtentwicklung wird eine fehlgeleitete Selbstmedikation mit psychotropen Substanzen zur Linderung der ADHS-Symptome angenommen. Behandlungsansätze: Bei ADHS sind Stimulanzien Medikamente der ersten Wahl. Bei komorbider Sucht, muss eine individuelle Risiko-Nutzen-Abwägung unter Berücksichtigung von Haltequoten und Wechselwirkungen zwischen ADHS-Medikamenten und Suchtmitteln erfolgen. Achtsamkeitsbasierte Verfahren und Neurofeedbackmethoden gelten als ergänzende Behandlungsformen. Schlussfolgerungen: Eine konsequente Behandlung des ADHS ab der Kindheit gilt als präventiv für die Suchtentwicklung. Die Behandlung der Komorbidität von ADHS und Sucht sollte integrativ unter Einbezug von Pharmakotherapie, Psychoedukation und Verhaltenstrainings erfolgen.

Summary

Objective and aim: Review of the comorbidity of ADHD and addiction in adulthood. Prevalence of ADHD in childhood is 5%, while the disorder is associated with an increased risk of the development of addiction with an estimated ADHD-prevalence to 23,1% in dependent adults. ADHD causes impairment in human devolpment. Selfmedication hypothesis is supposed as the main reason for the development of a substance use disorder, as psychotropic substances were used to reduce symptoms of ADHD. Teatment approaches: Stimulants are the first choice drugs for the treatment of ADHD. Referring to the comorbidity of ADHD and substance use disorder the risk and benefits of medication must be considered individually in relation to adherence to therapy and interactions between ADHD-medication and consumed drugs. Mindfulness based therapies and neurofeedback methods showed effectiveness as adjunct treatment forms. Conclusions: The consistent treatment of ADHD in childhood has shown to be preventative for later development of a substance use disorder. The teatment of ADHD and addiction should integrate medication, psychoeducation and behavioural trainings.

Schlüsselwörter

ADHS - Abhängigkeiten - Sucht - Komorbidität ADHS und süchtiges Verhalten

Keywords

ADHS - dependence - addiction - comorbidity ADHD and addictive behaviour - substance use disorder

Full Text

References

Literatur
1 Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, Faraone SV, Greenhill LL, Howes MJ, Secnik K, Spencer T, Ustun TB, Walters EE, Zaslavsky AM. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry 2006; 163: 716-723.
2 Schou Andreassen C, Billieux J, Griffiths MD, Kuss DJ, Demetrovics Z, Mazzoni E, Pallesen S. The relationship between addictive use of social media and video games and symptoms of psychiatric disorders: A large-scale cross-sectional study. Psychol Addict Behav 2016; 30: 252-262.
3 Johann M, Bobbe G, Putzhammer A, Wodarz N. Comorbidity of alcohol dependence with attention-deficit hyperactivity disorder: differences in phenotype with increased severity of the substance disorder, but not in genotype (serotonin transporter and 5-hydroxytryptamine-2c receptor). Alcohol Clin Exp Res 2003; 27: 1527-34.
4 Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol 2014; 43: 434-42.
5 Faraone SV, Biederman J, Mick E. The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of followup studies. Psychol Med 2006; 36: 159-165.
6 Simon V, Czobor P, Balint S, Meszaros A, Bitter I. Prevalence and correlates of adult attention-deficit hyperactivity disorder: metaanalysis. Br J Psychiatry 2009; 194: 204-211.
7 Torgersen T, Gjervan B, Lensing MB, Rasmussen K. Optimal management of ADHD in older adults. Neuropsychiatr Dis Treat 2016; 12: 79-87.
8 van Emmerik-van Oortmerssen K, van de Glind G, van den Brink W, Smit F, Crunelle CL, Swets M, Schoevers RA. Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: a meta-analysis and meta-regression analysis. Drug Alcohol Depend 2012; 122: 11-9.
9 van Emmerik-van Oortmerssen K, van de Glind G, Koeter MW, Allsop S, Auriacombe M, Barta C, Bu ET, Burren Y, Carpentier PJ, Carruthers S, Casas M, Demetrovics Z, Dom G, Faraone SV, Fatseas M, Franck J, Johnson B, Kapitány-Fövény M, Kaye S, Konstenius M, Levin FR, Moggi F, Møller M, Ramos-Quiroga JA, Schillinger A, Skutle A, Verspreet S, IASP research group. van den Brink W, Schoevers RA. Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: results of the IASP study. Addiction 2014; 109: 262-72.
10 van de Glind G, Konstenius M, Koeter MW, van Emmerik-van Oortmerssen K, Carpentier PJ, Kaye S, Degenhardt L, Skutle A, Franck J, Bu ET, Moggi F, Dom G, Verspreet S, Demetrovics Z, Kapitány-Fövény M, Fatséas M, Auriacombe M, Schillinger A, Møller M, Johnson B, Faraone SV, Ramos-Quiroga JA, Casas M, Allsop S, Carruthers S, Schoevers RA, Wallhed S, Barta C, Alleman P, IASP Research Group. Levin FR, van den Brink W. Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: Results from an international multi-center study exploring DSM-IV and DSM-5 criteria. Drug Alcohol Depend 2014; 134: 158-66.
11 Weinstein A, Yaacov Y, Manning M, Danon P, Weizman A. Internet Addiction and Attention Deficit Hyperctivity Disorder Among Schoolchildren. Isr Med Assoc J 2015; 17: 731-734.
12 Retz W, Ringling J, Retz-Junginger P, Vogelgesang M, Rösler M. Association of attention-deficit/hyperactivity disorder with gambling disorder. J Neural Transm (Vienna). 2016 Jun 21. Epub ahead of print
13 Caye A, Rocha TB, Anselmi L, Murray J, Menezes AM, Barros FC, Goncalves H, Wehrmeister F, Jensen CM, Steinhausen HC, Swanson JM, Kieling C, Rohde LA. Attention-Deficit/Hyperactivity Disorder Trajectories from Childhood to young adulthood: Evidence from a birth Cohort supporting a late-onset syndrome. JAMA Psychiatry. 2016 Mai. doi:
14 Ebert D, Krause J, Roth-Sackenheim C. ADHD in adulthood-guidelines on expert consensus with GPPN support. Nervenarzt 2003; 74: 939-946.
15 Larsson H, Chang Z, D‘Onofrio BM, Lichtenstein P. The heritability of clinically diagnosed attention deficit hyperactivity disorder across the lifespan. Psychol Med 2013; 10: 1-7.
16 Volkow ND, Wang GJ, Newcorn JH, Kollins SH, Wigal TL, Telang F, Fowler JS, Goldstein RZ, Klein N, Logan J, Wong C, Swanson JM. Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway. Mol Psychiatry 2011; 16: 1147-54.
17 Gold MS, Blum K, Oscar-Berman M, Baverman ER. Low dopamine function in attention deficit/hyperactivity disorder: should genotyping signify early diagnosis in children?. Postgrad Med 2014; 126: 153-177.
18 Mergy MA, Gowrishankar R, Davis GL, Jessen TN, Wright J, Stanwood GD, Hahn MK, Blakely RD. Genetic targeting of the amphetamine and methylphenidate-sensitive dopamine transporter: On the path to an animal model of attention-deficit hyperactivity disorder. Neurochem Int 2014; 73: 56-70.
19 Young S, Sedgwick O. Attention deficit hyperactivity disorder and substance misuse: an evaluation of causal hypotheses and treatment considerations. Expert Rev Neurother 2015; 15: 1005-1014.
20 Nutt DJ, Lingford-Hughes A, Erritzoe D, Stokes PR. The dopamine theory of addiction: 40 years of highs and lows. Nat Rev Neurosci 2015; 16: 305-312.
21 Murch WS, Clark L. Games in the Brain: Neural Substrates of Gambling Addiction. Neuroscientist 2015; Jun 26. 1073858415591474
22 Molina BS, Pelham WE. Attention-Deficit/Hyperactivity Disorder and Risk of Substance Use Disorder: Developmental Considerations, Potential Pathways, and Opportunities for Research. Annu Rev Clin Psychol 2014; 10: 607-639.
23 De Sousa A, Kalra G. Drug therapy of attention deficit hyperactivity disorder: current trends. Mens Sana Monogr 2012; 10: 45-69.
24 Volkow ND, Swanson JM. Variables that affect the clinical use and abuse of methylphenidate in the treatment of ADHD. Am J Psychiatry 2003; 160: 1909-1918.
25 Clemow DB, Walker DJ. The potential for misuse and abuse of medications in ADHD: a review. Postgrad Med 2014; 126: 64-81.
26 Rucklidge JJ, Johnstone J, Forman B, Boggis A, Frampton CM. Moderators of treatment response in adults with ADHD treated with a vitamin-mineral supplement. Prog Neuropsychopharmacol Biol Psychiatry 2014; 50: 163-171.
27 Frölich J, Banaschewski T, Döpfner M, Görtz-Dorten A. An evaluation of the pharmacokinetics of methylphenidate for the treatment of attention-deficit/hyperactivity disorder. Expert Opin Drug Metab Toxicol 2014; 10: 1169-83.
28 Berlin I, Hu MC, Cobey LS, Winhusen T. Attention-deficit/hyperactivity disorder (ADHD) symptoms, craving to smoke, and tobacco withdrawal symptoms in adult smokers with ADHD. Drug Alcohol Depend 2012; 124: 268-273.
29 Konstenius M, Jayaram-Lindström N, Guterstam J, Beck O, Philips B, Franck J. Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance dependence: a 24-week randomized placebo-controlled trial. Addiction 2014; 109: 440-449.
30 Dürsteler KM, Berger EM, Strasser J, Caflisch C, Mutschler J, Herdener M, Vogel M. Clinical potential of methylphenidate in the treatment of cocaine addiction: a review oft he current evidence. Subst Abuse Rehabil 2015; 6: 61-74.
31 Cunill R, Castells X, Tobias A, Capella D. Pharmacological treatment of attention deficit hyperactivity disorder with co-morbid drug dependence. J Psychopharmacol 2015; 29: 15-23.
32 Safren SA, Sprich S, Mimiaga MJ, Surman C, Knouse L, Groves M. Cognitive behavioral therapy vs relaxation with educational support for medication-treated adults with ADHD and persistent symptoms: a randomized controlled trial. JAMA 2010; 304: 875-880.
33 Cairncross M, Miller CJ. The effectiveness of mindfulness-based therapies for ADHD: A Meta-Analytic Review. J Atten Disord 2016; Feb 2. 1087054715625301
34 Cassone AR. Mindfulness training as an adjunct to evidence-based treatment for ADHD within families. J Atten Disord 2015; 19: 147-157.
35 Edel MA, Hölter T, Wassink K, Juckel G. A comparison of mindfulness-based group training and skills group training in adults with ADHD: an open study. J Atten Disord 2014; Oct 9. 1087054714551635
36 Bueno VF, Kozasa EH, da Silva MA, Alves TM, Luza MR, Pompeia S. Mindfulness meditation improves mood, quality of life, and attention in adults with attention deficit hyperactivity disorder. Biomed Res Int. 2015 doi:
37 Modesto-Lowe V, Farahmand P, Chaplin M, Sarro L. Does mindfulness meditation improve attention in attention deficit hyperactivity disorder?. World J Psychiatry 2015; 5: 397-403.
38 Mayer K, Wyckoff SN, Srehl U. Underarousal in adult ADHD: how are peripheral and vertical arousal related?. Clin EEG Neurosci 2015; 1550059415577544
39 Mayer K, Wyckoff SN, Fallgatter AJ, Strehl U. Neurofeedback as a nonpharmacological treatment for adults with attention-deficit/hyperactivity disorder (ADHD): study protocol for a randomized controlled trial. Trials 2015; 16: 174.
40 Greer SM, Trujillo AJ, Glover GH, Knutson B. Control of nucleus accumbens activity with neurofeedback. Neuroimage 2014; 96: 237-244.
41 Val-Laillet D, Aarts E, Weber B, Ferrari M, Quaresima V, Stoeckel LE, Alonso-Alonso M, Audette M, Malbert CH, Stice E. Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity. Neuroimage Clin 2015; 8: 1-31.