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Fortschr Neurol Psychiatr 2013; 81(8): 444-451
DOI: 10.1055/s-0033-1335657
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung bei Erwachsenen mit assoziierter Symptomatik und komorbiden psychiatrischen Erkrankungen: Diagnostik und medikamentöse Behandlung

Adult Attention Deficit/Hyperactivity Disorder, Associated Symptoms and Comorbid Psychiatric Disorders: Diagnosis and Pharmacological Treatment
G. Paslakis
,
M. Schredl
,
B. Alm
,
E. Sobanski
Further Information

Publication History

Publication Date:
17 July 2013 (online)

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Zusammenfassung

Die Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) des Erwachsenenalters ist eine häufige psychiatrische Erkrankung mit Beginn im Kindesalter und wird durch die Kernsymptome Aufmerksamkeitsstörungen, Hyperaktivität und impulsives Verhalten gekennzeichnet. Neben der Kernsymptomatik liegen häufig weitere Symptome, insbesondere emotionale Labilität, Schlafstörungen und Selbstwertbeeinträchtigungen und/oder komorbide psychiatrische Erkrankungen, v. a. depressive Episoden, Suchterkrankungen und Angststörungen vor. Diagnostik und Behandlung der ADHS des Erwachsenenalters sollten daher auch assoziierte Symptomatik und komorbide psychiatrische Erkrankungen umfassen. Erfolgt eine Einordnung der assoziierten Symptomatik als ADHS-inhärent, sollte zunächst die ADHS spezifisch behandelt und die assoziierte Symptomatik im Verlauf beobachtet werden. Wird die zusätzlich vorliegende Symptomatik als eigenständige psychiatrische Störung eingeordnet, sollte die psychiatrische Erkrankung mit der größten Krankheitsschwere vorrangig und störungsspezifisch behandelt werden. Die vorliegende Übersicht stellt den aktuellen Wissensstand zur Differenzialdiagnostik und Behandlung der ADHS des Erwachsenenalters mit assoziierten Symptomen und komorbiden psychiatrischen Erkrankungen entsprechend den Empfehlungen internationaler Leitlinien, klinischer Studien und Expertenmeinungen vor.

Abstract

Adult attention deficit/hyperactivity disorder (ADHD) is characterised by inattention and/or hyperactivity and impulsivity and is a frequent psychiatric disorder with childhood onset. In addition to core symptoms, patients often experience associated symptoms like emotional dysregulation or low self-esteem and suffer from comorbid disorders, particularly depressive episodes, substance abuse, anxiety or sleep disorders. It is recommended to include associated symptoms and comorbid psychiatric disorders in the diagnostic set-up and in the treatment plan. Comorbid psychiatric disorders should be addressed with disorder-specific therapies while associated symptoms also often improve with treatment of the ADHD core symptoms. The most impairing psychiatric disorder should be treated first. This review presents recommendations for differential diagnosis and treatment of adult ADHD with associated symptoms and comorbid psychiatric disorders with respect to internationally published guidelines, clinical trials and expert opinions.

Schlüsselwörter

ADHS des Erwachsenenalters - depressive Episode - Suchterkrankung - Angststörung - Schlafstörung

Key words

adult ADHD - depression - substance abuse disorder - anxiety disorder - sleep disorder
 

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