Skip to main content
SpringerLink
Log in

Komorbidität bei ADHS

Comorbidity in ADHD

  • Leitthema
  • Published:
Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

Zusammenfassung

Die Aufmerksamkeitsdefizit-Hyperaktivitäts-Störung (ADHS) tritt sehr häufig in Kombination mit anderen Störungsbildern auf. Die Abklärung und Berücksichtigung dieser Komorbiditäten stellt somit im klinischen Alltag eine zentrale Aufgabe und Herausforderung dar. In den letzten 10 Jahren wurden auch in der Forschung verstärkt Bemühungen unternommen, die Hintergründe und die Dynamik von komorbiden Störungen bei ADHS zu spezifizieren. Im folgenden Beitrag wird zunächst ein Überblick über aktuelle theoretische Modelle zum Verständnis von Komorbidität an sich gegeben. Darauf aufbauend werden die Prävalenzen sowie der aktuelle Forschungsstand zu genetischen und kognitiven Aspekten der relevantesten Komorbiditäten von ADHS im Kindes- und Jugendalter (Lese-Rechtschreib-Schwäche, Dyskalkulie, Störung des Sozialverhaltens, Depression, Angststörungen) dargestellt. Ausgehend von diesen Befunden werden die derzeit plausibelsten Erklärungen für die jeweiligen Komorbiditäten sowie die damit verbundenen Implikationen für die Praxis diskutiert. Angesichts dieser komplexen Zusammenhänge muss komorbiden Störungen bei ADHS in Zukunft verstärkt Aufmerksamkeit gewidmet werden.

Abstract

Attention-deficit hyperactivity disorder (ADHD) is frequently associated with other neuropsychiatric childhood disorders. Thus, the clarification and routine assessment of these comorbidities should be a major focus in clinical practice (i.e., in diagnosing and treating children suffering from ADHD). Over the past decade scientific endeavors targeted at better characterizing the background and dynamics of ADHD-associated comorbidities increased considerably. The main aims of this article are: (a) to present an overview of current conceptualizations of comorbidities, and (b) to provide the reader with the prevalence rates as well as the genetic and cognitive aspects of ADHD-associated disorders (e.g., dyslexia, dyscalculia, oppositional defiant disorders, depression, anxiety). Based on the presented findings, the currently most plausible explanations for the respective comorbidities as well as their implications for clinical practice will be discussed. Overall, greater attention should be devoted to the complex interplay between ADHD and associated disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Bauermeister JJ, Shrout PE, Ramirez R et al. (2007) ADHD correlates, comorbidity, and impairment in community and treated samples of children and adolescents. J Abnorm Child Psychol 35: 883–898

    Article  PubMed  Google Scholar 

  2. Bauermeister JJ, Shrout PE, Chávez L et al. (2007) ADHD and gender: are risks and sequela of ADHD the same for boys and girls? J Child Psychol Psychiatry 48: 831–839

    Article  PubMed  Google Scholar 

  3. Biederman J, Faraone SV, Keenan K et al. (1991) Familial association between attention deficit disorder and anxiety disorders. Am J Psychiatry 148: 251–256

    PubMed  CAS  Google Scholar 

  4. Biederman J, Faraone SV, Keenan K et al. (1992) Further evidence for family-genetic risk factors in attention deficit hyperacitivity disorder. Patterns of comorbidity in probands and relatives psychiatrically and pediatrically referred samples. Arch Gen Psychiatry 49: 728–738

    PubMed  CAS  Google Scholar 

  5. Biederman J, Ball S, Monuteaux M et al. (2008) New insights into the comorbiditiy between ADHD and major depression in adolescent and young adult females. J Am Acad Child Adolesc Psychiatry 47: 427–435

    Article  Google Scholar 

  6. Bowen R, Chavira DA, Bailey K et al (2008) Nature of anxiety comorbid with attention deficit hyperactivity disorder in children from a pediatric primary care setting. Psychiatry Res 157: 201–209

    Article  PubMed  Google Scholar 

  7. Casey JE, Rourke BP, Del Dotto JE (1996) Learning disabilities in children with attention deficit disorder with and without hyperactivity. Child Neuropsychol 2: 83–98

    Article  Google Scholar 

  8. Cataldo MG, Nobile M, Lorusso ML et al. (2005) Impulsivity in depressed children and adolescents: a comparison between behavioral and neuropsychological data. Psychiatry Res 136: 123–133

    Article  PubMed  Google Scholar 

  9. Drabick DAG, Gadow KD, Sprafkin J (2006) Co-occurrence of conduct disorder and depression in a clinic-based sample of boys with ADHD. J Child Psychol Psychiatry 47: 766–774

    Article  PubMed  Google Scholar 

  10. Faraone SV, Biederman J, Mennin D (1997) Attention-deficit hyperactivity disorder with bipolar disorder: a familial subtype? J Am Acad Child Adolesc Psychiatry 36: 1378–1387

    Article  PubMed  CAS  Google Scholar 

  11. Fawcett AJ, Nicolson RI (1992) Automatisation deficits in balance for dyslexic children. Percept Mot Skill 75: 507–529

    Article  CAS  Google Scholar 

  12. Gilger JW, Pennington BF, DeFries JC (1992) A twin study of the etiology of comorbidity: attention-deficit hyperactivity disorder and dyslexia. J Am Acad Child Adolesc Psychiatry 31: 343–348

    Article  PubMed  CAS  Google Scholar 

  13. Henin A, Mick E, Biederman J et al. (2007) Can bipolar disorder-specific neuropsychological impairments in children be identified? J Consult Clin Psychol 75: 210–220

    Article  PubMed  Google Scholar 

  14. Jain M, Palacio LG, Castellanos FX et al. (2007) Attention-deficit/hyperactivity disorder and comorbid disruptive behavior disorders: evidence of pleiotropy and new susceptibility loci. Biol Psychiatry 61: 1329–1339

    Article  PubMed  CAS  Google Scholar 

  15. Kaufmann L (2002) More evidence for the role of the central executive in retrieving arithmetic facts – a case study of severe developmental dyscalculia. J Clin Exp Neuropsychol 24: 302–310

    Article  PubMed  Google Scholar 

  16. Kaufmann L, Nuerk HC (2008) Basic number processing deficits in ADHD: a broad examination of elementary and complex number processing skills in 9- to 12-year old children with ADHD-C. Dev Sci 11: 692–699

    Article  PubMed  Google Scholar 

  17. Korenblum CB, Chen SX, Manassis K et al. (2007) Performance monitoring and response inhibition in anxiety disorders with and without comorbid adhd. Depress Anxiety 24: 227–232

    Article  PubMed  Google Scholar 

  18. Landerl K, Bevan A, Butterworth B (2004) Developmental dyscalculia and basic numerical capacities: a study of 8–9-year-old students. Cognition 93: 99–125

    Article  PubMed  Google Scholar 

  19. Levy F, Hay DA, Bennett KS et al. (2004) Gender differences in ADHD subtype comorbidity. J Am Acad Child Adolesc Psychiatry 44: 368–376

    Article  Google Scholar 

  20. Lynam DR (1996) Early identification of chronic offenders: who is the fledgling psychopath? Psychol Bull 120: 209–234

    Article  PubMed  CAS  Google Scholar 

  21. Masi G, Perugi G, Toni C et al (2006) Attention-deficit hyperactivity disorder – bipolar comorbidity in children and adolescents. Bipolar Disord 8: 373–381

    Article  PubMed  Google Scholar 

  22. Milich R, Balentine AC, Lynam DR (2001) ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders. Clin Psychol Sci Prac 8: 463–488

    Article  Google Scholar 

  23. Monuteaux MC, Faraone SV, Herzig K et al (2005) ADHD and dyscalculia: evidence for independent familial transmission. J Learn Disabil 38: 86–93

    Article  PubMed  Google Scholar 

  24. Neale MC, Kendler KS (1995) Models of comorbidity for multifactorial disorders. Am J Hum Genet 57: 935–53

    PubMed  CAS  Google Scholar 

  25. Newcorn JH, Halperin JM (2000) Attention-deficit disorders with oppositionality and aggression. In: Brown TE (Ed) Attention-deficit disorders and comorbidities in children, adolescents and adults. American Psychiatric Press, Washington, pp 171–207

  26. Nicolson R, Fawcett A (1990) Automaticity: a new framework for dyslexia research? Cognition 35: 159–182

    Article  PubMed  CAS  Google Scholar 

  27. Oosterlaan J, Scheres A, Sergeant JA (2005) Which executive functioning deficits are associated with AD/HD, ODD/CD and comorbid AD/HD+ODD/CD? J Abnorm Child Psychol 33: 69–85

    Article  PubMed  Google Scholar 

  28. Ostrander R, Herman KC (2006) Potential cognitive, parenting, and developmental mediators of the relationship between ADHD and depression. J Consult Clin Psychol 74: 89–98

    Article  PubMed  Google Scholar 

  29. Passolunghi MC, Marzocchi GM, Fiorillo F (2005) Selective effect of inhibition of literal or numerical irrelevant information in children with attention deficit hyperactivity disorder (ADHD) or arithmetic learning disorder (ALD). Dev Neuropsychol 28: 731–753

    Article  PubMed  Google Scholar 

  30. Pennington BF (2006) From single to multiple deficit models of developmental disorders. Cognition 101: 385–413

    Article  PubMed  Google Scholar 

  31. Pennington BF, Groisser D, Welsh MC (1993) Contrasting cognitive deficits in attention deficit hyperactivity disorder versus reading disability. Dev Psychol 29: 511–523

    Article  Google Scholar 

  32. Pennington BF, Willcutt E, Rhee SH (2005) Analyzing comorbidity. In: Kail RV (ed) Advances in child development and behavior. Elsevier, Oxford New York, pp 263–304

  33. Perrin S, Last CG (1996) Relationship between ADHD and anxiety in boys: results from a family study. J Am Acad Child Adolesc Psychiatry 35: 988–996

    Article  PubMed  CAS  Google Scholar 

  34. Power TJ, Costigan TE, Eiraldi RB et al. (2004) Variations in anxiety and depression as a function of ADHD subtypes defined by DSM-IV: do subtype differences exist or not? J Abnorm Child Psychol 32: 27–37

    Article  PubMed  Google Scholar 

  35. Pliszka SR, Carlson CL, Swanson JM (1999) ADHD with comorbid disorders. Clinical assessment and management. Guilford Press, New York

  36. Raberger T, Wimmer H (2003) On the automaticity/cerebellar deficit hypothesis of dyslexia: balancing and continuous rapid naming in dyslexic and ADHD children. Neuropsychologia 41: 1493–1497

    Article  PubMed  Google Scholar 

  37. Rhee SH, Willcutt EG, Hartman CA et al. (2008) Test of alternative hypotheses explaining the comorbidity between attention-deficit/hyperacitivity disorder and conduct disorder. J Abnorm Child Psychol 36: 29–40

    Article  PubMed  Google Scholar 

  38. Rubinsten O, Henik A (2005) Automatic activation of internal magnitude: a study of developmental dyscalculia. Neuropsychology 19: 641–648

    Article  PubMed  Google Scholar 

  39. Rubinsten O, Henik A (2006) Double dissociation of functions in developmental dyslexia and dyscalculia. J Educ Psychol 98: 854–867

    Article  Google Scholar 

  40. Schatz DB, Rostain AL (2006) ADHD with comorbid anxiety. A review of the current literatur. J Attent Disord 10: 141–149

    Article  Google Scholar 

  41. Semrud-Clikeman M, Biederman J, Sprich-Buckminster S et al. (1992) Comorbidity between ADHD and learning disability: a review and report in a clinically referred sample. J Am Acad Child Adolesc Psychiatry 31: 439–448

    Article  PubMed  CAS  Google Scholar 

  42. Shalev RS, Auerbach J, Gross-Tsur V (1995) Developmental dyscalculia behavioral and attentional aspects: a research note. J Child Psychol Psychiatry 36: 1261–1268

    Article  PubMed  CAS  Google Scholar 

  43. Shanahan MA, Pennington BF, Yerys BE et al. (2006) Processing speed deficits in attention deficit/hyperactivity disorder and reading disability. J Abnorm Child Psychol 34: 585–602

    Article  PubMed  Google Scholar 

  44. Singh MK, DelBello MP, Kowatch RA et al. (2006) Review article: co-occurrence of bipolar and attention-deficit hyperactivity disorders in children. Bipolar Disord 8: 710–720

    Article  PubMed  Google Scholar 

  45. Spencer T, Wilens T, Biederman J et al. (2000) Attention-deficit/hyperactivity disorder with mood disorder. In: Brown TE (ed) Attention-deficit disorders and comorbidities in children, adolescents, and adults. American Psychiatric Press, Washington, pp 79–124

  46. Stevenson J, Langley K, Pay H et al. (2005) Attention deficit hyperactivity disorder with reading disabilities: preliminary genetic findings on the involvement of the ADRA2A gene. J Child Psychol Psychiatry 46: 1081–1088

    Article  PubMed  CAS  Google Scholar 

  47. Tannock R (2000) Attention-deficit/hyperactivity disorder with anxiety disorders. In: Brown TE (ed) Attention-deficit disorders and comorbidities in children, adolescents, and adults. American Psychiatric Press, Washington, pp 125–170

  48. Tannock R, Martinussen R, Frijters J (2000) Naming speed performance and stimulant effects indicate effortful, semantic processing deficits in attention-deficit/hyperactivity disorder. J Abnorm Child Psychol 28: 237–252

    Article  PubMed  CAS  Google Scholar 

  49. Vellutino FR, Fletcher JM, Snowling MJ et al. (2004) Specific reading disability (dyslexia): what have we learned in the past four decades? J Child Psychol Psychiatry 45: 2–40

    Article  PubMed  Google Scholar 

  50. Waschbusch DA, Pelham WE, Jennings JR (2002) Reactive aggression in boys with disruptive behaviour disorders: behaviour, physiology, and affect. J Abnorm Child Psychol 30: 641–656

    Article  PubMed  Google Scholar 

  51. Willcutt EG, Pennington BF, Olson RK et al. (2007) Understanding comorbiditiy: a twin study of reading disability and attention-deficit/hyperactivity disorder. Am J Med Gen B Neuropsychiatr Gen 144: 709–714

    Article  Google Scholar 

  52. Wilkinson PO, Goodyer IM (2006) Attention difficulties and mood-related ruminative response style in adolescents with unipolar depression. J Child Psychol Psychiatry 47: 1284–1291

    PubMed  Google Scholar 

  53. Wilson A, Dehaene S (2007) Number sense and developmental dyscalculia. In: Coch D, Dawson G, Fischer K (eds) Human behavior, learning, and the developing brain: atypical development. Guilford Press, New York, pp 212–238

  54. Wolf M, Bowers PG (1999) The double-deficit hypothesis for the developmental dyslexias. J Educ Psychol 91: 415–438

    Article  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Fachbereich Psychologie, Universität Salzburg, Hellbrunner Straße 34, A-5020, Salzburg, Österreich

    W. Kain

  2. Abteilung für Entwicklungspsychologie, Psychologisches Institut, Universität Tübingen, Tübingen, Deutschland

    K. Landerl

  3. Arbeitsgruppe Neuropädiatrie, Department Pädiatrie IV, Medizinische Universität Innsbruck, Innsbruck, Österreich

    L. Kaufmann

Authors
  1. W. Kain
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Landerl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Kaufmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. Kain.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kain, W., Landerl, K. & Kaufmann, L. Komorbidität bei ADHS. Monatsschr Kinderheilkd 156, 757–767 (2008). https://doi.org/10.1007/s00112-008-1732-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00112-008-1732-9

Schlüsselwörter

Keywords

Search

Navigation