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Autismus und ADHS über die Lebensspanne

Differenzialdiagnosen oder Komorbidität?

Autism and ADHD across the life span

Differential diagnoses or comorbidity?

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Zusammenfassung

Autismusspektrumstörungen („autism spectrum disorders“, ASD) gelten in den beiden aktuellen Klassifikationssystemen (ICD-10 und DSM-IV-TR) als Ausschlusskriterium für die Diagnose einer Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS). Unaufmerksamkeit, Impulsivität und Hypermotorik gehören aber zu den häufigsten Begleitsymptomen der ASD. Psychopathologische, neuropsychologische, bildgebende und genetische Untersuchungen weisen auf mögliche pathophysiologische Zusammenhänge von autistischen Störungen und ADHS hin. Bei der Diagnostik beider Störungen sollte daher grundsätzlich geprüft werden, ob auch Symptome der anderen Störungen vorliegen. Die Behandlung der ADHS-Symptome bei Autismus gleicht zwar prinzipiell der Therapie nichtautistischer Kinder mit ADHS. Allerdings sind oft niedrigere Dosierungen und eine langsamere Titration empfehlenswert.

Summary

Exclusion criteria of the DSM-IV-TR and ICD-10 do prevent dual diagnoses of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD). However, inattention, impulsivity and hyperactivity are amongst the most frequent associated symptoms of ASD. Psychopathological, neuropsychological, brain imaging and genetic studies suggest possible pathophysiological links between ASD and ADHD. Thus, standard diagnostic procedures for both disorders should assess the presence of potential comorbid symptoms of the other disorder. Treatment strategies for ADHD symptoms in the context of ASD overlap with those for patients with ADHD, but lower dosages and slower titration might be recommendable.

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Interessenkonflikte

Der korrespondierende Autor weist auf folgende Beziehungen hin: Prof. M. Holtmann: Mitglied in Advisory Boards von Lilly, Bristol-Myers Squibb, Novartis; Vortragshonorare/Kongressreisen von AstraZeneca, BMS, Janssen-Cilag, Lilly, Medice, Merz, neuroConn, Novartis, Shire; Forschungsförderung von Deutsche Forschungsgemeinschaft DFG und BMBF. Dr. L. Poustka: Vortragshonorare/Kongressreisen von Shire und Lilly. T. Banaschewski: Advisory Board oder Beratungstätigkeit für Bristol Myers-Sqibb, Desitin, Lilly, Medice, Novartis, Pfizer, Shire, UCB und Viforpharma. Reisekosten für Konferenzen oder Vortragshonorare von Lilly, Janssen McNeil, Medice, Novartis, Shire, UCB. Beteiligung an klinischen Studien von Lilly, Shire und Novartis.

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  1. Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für seelische Gesundheit, J 5, 68159, Mannheim, Deutschland

    T. Banaschewski & L. Poustka

  2. Kinder- und Jugendpsychiatrie - Psychotherapie - Psychosomatik, LWL-Universitätsklinik Hammder Ruhr-Universität Bochum, Hamm, Deutschland

    M. Holtmann

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  1. T. Banaschewski
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Banaschewski, T., Poustka, L. & Holtmann, M. Autismus und ADHS über die Lebensspanne. Nervenarzt 82, 573–581 (2011). https://doi.org/10.1007/s00115-010-3239-6

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