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Erschienen in: Der Nervenarzt 7/2020

07.04.2020 | ADHS | Leitthema

Adulte Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung und Komorbidität: neue Befunde zu epidemiologischen und genetischen Faktoren

verfasst von: Prof. Dr. Sarah Kittel-Schneider, Andreas Reif

Erschienen in: Der Nervenarzt | Ausgabe 7/2020

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Zusammenfassung

Alle großen, bevölkerungsbasierten administrativen Studien sprechen aktuell für eine signifikante Komorbidität von adulter Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung (ADHS) mit Sucht‑, Angst- und vor allem Stimmungserkrankungen. Mit zunehmendem Alter steigt in diesen Untersuchungen das Risiko für eine dieser komorbiden Störungen an. Die neuesten genomweiten Assoziations- und Korrelationsstudien geben zudem Hinweise für gemeinsame genetische Risikofaktoren der ADHS mit insbesondere unipolarer Depression, bipolarer Störung, Autismusspektrumstörungen, Tourette-Syndrom und zu einem geringeren Maße mit Schizophrenie. Die einzige negative genetische Korrelation zeigte sich mit Anorexia nervosa. Auch Kokain- und Cannabiskonsum sind signifikant positiv genetisch mit ADHS korreliert. Zudem konnten bei einigen spezifischen somatischen Erkrankungen ein erhöhtes Auftreten bei Patienten mit adulter ADHS gefunden werden. Besonders signifikant waren diese positiven Assoziationen bei Übergewicht, Migräne, Schlafstörungen, Asthma und Zöliakie. Keine Assoziation wurde für ADHS und Erkrankungen des Herz-Kreislauf-Systems gefunden. Auch hier gibt es erste Hinweise auf gemeinsame Risikogene, die Datenlage ist aber noch nicht ausreichend, um abschließende Feststellungen zu machen. Zum Teil handelt es sich bei den assoziierten somatischen Erkrankungen wohl auch um Differenzialdiagnosen, wenn sich die ADHS-Symptomatik nach adäquater Behandlung wie z. B. bei einer obstruktiven Schlafapnoe verbessert. Umso wichtiger ist es aber, diese psychischen und somatischen Differenzialdiagnosen und Komorbiditäten bei der Diagnostik und Behandlung adulter ADHS-Patienten im Blick zu haben, um deren generelle Gesundheit und Lebensqualität zu verbessern.
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Metadaten
Titel
Adulte Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung und Komorbidität: neue Befunde zu epidemiologischen und genetischen Faktoren
verfasst von
Prof. Dr. Sarah Kittel-Schneider
Andreas Reif
Publikationsdatum
07.04.2020
Verlag
Springer Medizin
Erschienen in
Der Nervenarzt / Ausgabe 7/2020
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI
https://doi.org/10.1007/s00115-020-00900-5

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