ADHS und Sucht im Erwachsenenalter

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

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