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Konzeptualisierung der Psychotherapie bei ADHS und Sucht

Published Online:October 22, 2015https://doi.org/10.1024/0939-5911.a000387

Abstract

Zusammenfassung.Zielsetzung: Das komorbide Auftreten der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) und substanzbezogener Störungen (SUD) ist häufig und hat einen negativen Einfluss auf den Behandlungserfolg. Studien zur Wirksamkeit ADHS-spezifischer Medikamente bei dem komorbiden Auftreten beider Störungen kommen zu uneinheitlichen Ergebnissen. Einheitlich wird allerdings eine psychotherapeutische Behandlung bei dieser Patientengruppe empfohlen, während bislang jedoch kein evaluiertes Behandlungskonzept veröffentlich wurde. Ziel dieser Arbeit ist ein Überblick zu psychotherapeutischen Ansätzen bei beiden Störungsbildern und einen Ausblick auf psychotherapeutische Ansätze für das gemeinsame Auftreten beider Störungen zu geben. Methodik: Die Zusammenstellung der Literatur erfolgte auf Basis einer Medline-, PsycINFO- und Google Scholar-Recherche (Schlüsselwörter: substance abuse, adhd, psychotherapy, therapy, methylphenidate, atomoxetine, bupropion, CBT, relapse prevention, mindfulness, MBRP, DBT). Ergebnisse: Psychotherapeutische Ansätze zur Behandlung der ADHS im Erwachsenenalter und von SUD überschneiden sich inhaltlich. Als wirksam erweisen sich CBT- und achtsamkeitsbasierte Verfahren sowie die DBT. Schlussfolgerung: Eine Kombination der oben dargestellten therapeutischen Ansätze könnte bei der Behandlung einer komorbid auftretenden ADHS und SUD sinnvoll sein. Hier bedarf es weiterer Forschungsarbeit.


Psychotherapy for Co-occurring ADHD and SUD

Abstract.Aims: Attention-deficit hyperactivity disorder (ADHD) and substance use disorder (SUD) often co-occur, which makes treatment very difficult. Investigations into the effectiveness of ADHD medications in co-occurring ADHD and SUD have resulted in contradictory results, whereas psychotherapy is presently recommended. However, there is a lack of studies on suitable psychotherapeutic approaches. This article provides readers with information about combined psychotherapy for ADHD and SUD. Additionally, it provides a perspective on psychotherapeutic approaches for co-occurring ADHD and SUD. Methods: An overview of the literature was compiled from Medline, PsycINFO and Google Scholar (keywords: substance abuse, ADHD, psychotherapy, therapy, methylphenidate, atomoxetine, bupropion, CBT, relapse prevention, mindfulness, MBRP, DBT). Results: Psychotherapeutic approaches for ADHD and SUD overlap. CBT, mindfulness and DBT appear to be effective. Conclusions: A combination of approaches may be useful in the treatment of comorbid ADHD and SUD. Further investigation is required.

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