Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Übersichten

Zur Komorbidität von aggressivem Verhalten und ADHS

Published Online:September 21, 2010https://doi.org/10.1026/0942-5403/a000029

Abstract

Bei Kindern und Jugendlichen treten aggressives Verhalten und ADHS häufig gemeinsam auf und führen vielfach zu erheblichen psychosozialen Belastungen. Durch eine Metaanalyse wird eine verlässliche Maßzahl zum komorbiden Auftreten von ADHS und aggressivem Verhalten bestimmt. Anhand der Datenbanken PsycINFO und Pubmed wurden Studien identifiziert, die neben den relevanten Suchbegriffen ausgewählte Einschlusskriterien erfüllten, unter anderem „Allgemeinbevölkerung“ und „strukturierte Interviewverfahren“. In die Berechnung gingen acht epidemiologische Studien ein (N = 29980). Die metaanalytische Betrachtung bestätigt die hohe Komorbidität von ADHS und aggressivem Verhalten mit einem mittleren Odds Ratio von 21. Dieses Ergebnis wird für die Ätiologie und den Krankheitsverlauf diskutiert. Relevante Schlussfolgerungen für Diagnostik und Therapie werden aufgezeigt.


Comorbidity of aggressive behavior and ADHD

Comorbid aggressive behavior (ODD/CD) and ADHD is common in childhood and adolescence and a risk factor for severe impairments. This study provides a meta-analysis of reliable studies of the comorbidity rate of ADHD and ODD/CD. The studies were identified from PsycINFO and Pubmed searches using relevant terms and several inclusion criteria, e. g., “general population” and “structured interviews.” Eight studies were included in the calculation (N = 29,980). In our study the high comorbidity between ADHD and ODD/CD is confirmed by an odds ratio of 21. This result is discussed from an etiological and psychopathological perspective, considering clinical implications.

Literatur

  • Bauermeister, J. J. , Shrout, P. E. , Ramirez, R. , Bravo, M. , Alegria, M. , Martinez-Taboas, A. et al. (2007). ADHD correlates, comorbidity, and impairment in community and treated samples of children and adolescents. Journal of Abnormal Child Psychology, 35, 883 – 898. First citation in articleCrossref, Google Scholar

  • Biederman, J. , Petty, C. R. , Dolan, C. , Hughes, S. , Mick, E. , Monuteaux, M. C. et al. (2008). The long-term longitudinal course of oppositional defiant disorder and conduct disorder in ADHD boys: Findings from a controlled 10-year prospective longitudinal follow-up study. Psychological Medicine, 38, 1027 – 1036. First citation in articleGoogle Scholar

  • Bird, H. R. , Davies, M. , Duarte, C. S. , Shen, S. , Loeber, R. , Canino, G. J. (2006). A study of disruptive behavior disorders in Puerto Rican youth: II. Baseline prevalence, comorbidity, and correlates in two sites. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1042 – 1053. First citation in articleCrossref, Google Scholar

  • Bird, H. R. , Shrout, P. E. , Duarte, C. S. , Shen, S. , Bauermeister, J. J. , Canino, G. (2008). Longitudinal mental health service and medication use for ADHD among Puerto Rican youth in two contexts. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 879 – 889. First citation in articleCrossref, Google Scholar

  • Burke, J. D. , Loeber, R. , Lahey, B. B. , Rathouz, P. J. (2005). Developmental transitions among affective and behavioral disorders in adolescent boys. Journal of Child Psychology and Psychiatry, 11, 1200 – 1210. First citation in articleCrossref, Google Scholar

  • Caron, C. , Rutter, M. (1991). Comorbidity in child psychopathology: Concepts, issues and research strategies. Journal of Child Psychology and Psychiatry, 32, 1063 – 1080. First citation in articleCrossref, Google Scholar

  • Cho, S. C. , Kim, B. N. , Kim, J. W. , Rohde, L. A. , Hwang, J. W. , Chungh, D. S. et al. (2009). Full syndrome and subthreshold attention-deficit/hyperactivity disorder in a Korean community sample: Comorbidity and temperament findings. European Child and Adolescent Psychiatry, 18, 447 – 457. First citation in articleCrossref, Google Scholar

  • Christiansen, H. , Chen, W. , Oades, R. D. , Asherson, P. , Taylor, E. A. , Lasky-Su, J. et al. (2008). Co-transmission of conduct problems with attention-deficit/hyperactivity disorder: Familial evidence for a distinct disorder. Journal of Neural Transmission, 115, 163 – 175. First citation in articleCrossref, Google Scholar

  • Costello, E. J. , Egger, H. , Angold, A. (2005). 10-year research update review: The epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 972 – 986. First citation in articleCrossref, Google Scholar

  • Costello, E. J. , Mustillo, S. , Erkanli, A. , Keeler, G. , Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837 – 844. First citation in articleCrossref, Google Scholar

  • Desman, C. , Petermann, F. (2005). Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS): Wie valide sind die Subtypen? Kindheit und Entwicklung, 14, 244 – 254. First citation in articleLink, Google Scholar

  • Dick, D. M. , Viken, R. J. , Kaprio, J. , Pulkkinen, L. , Rose, R. J. (2005). Understanding the covariation among childhood externalizing symptoms: Genetic and environmental influences on conduct disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder symptoms. Journal of Abnormal Child Psychology, 33, 219 – 229. First citation in articleCrossref, Google Scholar

  • Drabick, D. A. , Gadow, K. D. , Carlson, G. A. , Bromet, E. J. (2004). ODD and ADHD symptoms in Ukrainian children: External validators and comorbidity. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 735 – 743. First citation in articleCrossref, Google Scholar

  • Fleitlich-Bilyk, B. , Goodman, R. (2004). Prevalence of child and adolescent psychiatric disorders in Southeast Brazil. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 727 – 734. First citation in articleCrossref, Google Scholar

  • Ford, T. , Goodman, R. , Meltzer, H. (2003). The British Child and Adolescent Mental Health Survey 1999: The prevalence of DSM-IV disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 1203 – 1211. First citation in articleCrossref, Google Scholar

  • Gadow, K. D. , Sprafkin, J. , Schneider, J. , Nolan, E. E. , Schwartz, J. , Weiss, M. D. (2007). ODD, ADHD, versus ODD+ADHD in clinic and community adults. Journal of Attention Disorders, 11, 374 – 383. First citation in articleCrossref, Google Scholar

  • Gerber-von Müller, G. , Petermann, U. , Petermann, F. , Niederberger, U. , Stephani, U. , Siniatchkin, M. , Gerber, W.-D. (2009). Das ADHS-Summercamp–Entwicklung und Evaluation eines multimodalen Programms. Kindheit und Entwicklung, 18, 162 – 172. First citation in articleLink, Google Scholar

  • Gillberg, C. , Gillberg, I. C. , Rasmussen, P. , Kadesjo, B. , Soderstrom, H. , Rastam, M. et al. (2004). Co-existing disorders in ADHD–implications for diagnosis and intervention. European Child and Adolescent Psychiatry, 13, I80-I92. First citation in articleCrossref, Google Scholar

  • Goodman, R. (1997). Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581 – 586. First citation in articleCrossref, Google Scholar

  • Goodman, R. , Ford, T. , Richards, H. , Gatward, R. , Meltzer, H. (2000). The Development and Well-Being Assessment: Description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology and Psychiatry, 41, 645 – 655. First citation in articleCrossref, Google Scholar

  • Graetz, B. W. , Sawyer, M. G. , Baghurst, P. (2005). Gender differences among children with DSM-IV ADHD in Australia. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 159 – 168. First citation in articleCrossref, Google Scholar

  • Heiervang, E. , Stormark, K. M. , Lundervold, A. J. , Heimann, M. , Goodman, R. , Posserud, M.-B. et al. (2007). Psychiatric disorders in Norwegian 8- to 10-year-olds: An epidemiological survey of prevalence, risk factors, and service use. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 438 – 447. First citation in articleCrossref, Google Scholar

  • Hofvander, B. , Ossowski, D. , Lundstrom, S. , Anckarsater, H. (2009). Continuity of aggressive antisocial behavior from childhood to adulthood: The question of phenotype definition. International Journal of Law and Psychiatry, 32, 224 – 234. First citation in articleCrossref, Google Scholar

  • Jensen, P. S. , Rubio-Stipec, M. , Canino, G. , Bird, H. , Dulcan, M. K. , Schwab-Stone, M. E. et al. (1999). Parent and child contributions to diagnosis of mental disorder: Are both informants always necessary? Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1569 – 1579. First citation in articleCrossref, Google Scholar

  • Kadesjö, B. , Gillberg, C. (2001). The comorbidity of ADHD in the general population of Swedish school-age children. Journal of Child Psychology and Psychiatry, 42, 487 – 492. First citation in articleCrossref, Google Scholar

  • Kain, W. , Landerl, K. , Kaufmann, L. (2008). Komorbidität bei ADHS. Monatsschrift Kinderheilkunde, 156, 757 – 767. First citation in articleCrossref, Google Scholar

  • Klein, D. N. , Riso, L. P. (1993). Psychiatric disorders: Problems of boundaries and comorbidity. In C. G. Costello, (Ed.), Basic issues in psychopathology (pp. 19 – 66). New York: Guilford. First citation in articleGoogle Scholar

  • Lavigne, J. V. , LeBailly, S. A. , Hopkins, J. Gouze , K. R. & Binns, H. J. (2009). The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. Journal of Clinical Child and Adolescent Psychology, 38, 315 – 328. First citation in articleCrossref, Google Scholar

  • Lucas, C. P. , Zhang, H. , Fisher, P. W. , Shaffer, D. , Regier, D. A. , Narrow, W. E. et al. (2001) The DISC predictive scales (DPS): Efficiently screening for diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 443 – 449. First citation in articleCrossref, Google Scholar

  • Loeber, R. , Burke, J. D. , Lahey, B. B. , Winters, A. , Zera, M. (2000). Oppositional defiant and conduct disorder: A review of the past 10 years, Part I. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1468 – 1484. First citation in articleCrossref, Google Scholar

  • Munkvold, L. , Lundervold, A. , Lie, S. A. , Manger, T. (2009). Should there be separate parent and teacher-based categories of ODD? Evidence from a general population. Journal of Child Psychology and Psychiatry, 50, 1264 – 1272. First citation in articleCrossref, Google Scholar

  • Neale, M. C. , Kendler, K. S. (1995). Models of comorbidity for multifactorial disorders. American Journal of Human Genetics, 57, 935 – 953. First citation in articleGoogle Scholar

  • Nitkowski, D. , Petermann, F. , Büttner, P. , Krause-Leipoldt, C. , Petermann, U. (2009a). Behavior modification of aggressive children in child welfare. Behavior Modification, 33, 474 – 492. First citation in articleCrossref, Google Scholar

  • Nitkowski, D. , Petermann, F. , Büttner, P. , Krause-Leipold, C. , Petermann, U. (2009b). Verhaltenstherapie und Jugendhilfe–Ergebnisse zur Optimierung der Versorgung aggressiver Kinder. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 37, 461 – 468. First citation in articleLink, Google Scholar

  • Nock, M. K. , Kazdin, A. E. , Hiripi, E. , Kessler, R. C. (2007). Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: Results from the National Comorbidity Survey Replication. Journal of Child Psychology and Psychiatry, 48, 703 – 713. First citation in articleCrossref, Google Scholar

  • Pelham, W. E. , Fabiano, G. A. , Massetti, G. M. (2005). Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 449 – 476. First citation in articleCrossref, Google Scholar

  • Petermann, F. (2005). Zur Epidemiologie psychischer Störungen im Kindes- und Jugendalter. Kindheit und Entwicklung, 14, 48 – 57. First citation in articleLink, Google Scholar

  • Petermann, F. , Hampel, P. (2009). Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS). Kindheit und Entwicklung, 18, 135 – 136. First citation in articleLink, Google Scholar

  • Petermann, F. , Petermann, U. , Besier, T. , Goldbeck, L. , Büttner, P. , Krause-Leipoldt, C. , Nitkowski, D. (2008). Zur Effektivität des Trainings mit aggressiven Kindern in Psychiatrie und Jugendhilfe. Kindheit und Entwicklung, 17, 182 – 189. First citation in articleLink, Google Scholar

  • Petermann, U. , Petermann, F. , Damm, F. (2008). Entwicklungspsychopathologie der ersten Lebensjahre. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 56, 243 – 253. First citation in articleLink, Google Scholar

  • Petermann, U. , Reinartz, H. , Petermann, F. (2002). IDL 0 – 2: Ein Explorationsbogen zur Identifikation differentieller Lernwege in der Sozialentwicklung. Zeitschrift für Klinische Psychologie, Psychiatrie und Psychotherapie, 50, 427 – 457. First citation in articleGoogle Scholar

  • Polanczyk, G. , de Lima, M. S. , Horta, B. L. , Biederman J. & Rohde, L. A. (2007). The worldwide prevalence of ADHD: A systematic review and metaregression analysis. American Journal of Psychiatry, 164, 942 – 948. First citation in articleCrossref, Google Scholar

  • Rhee, S. H. , Willcutt, E. G. , Willcut, E. G. , Hartmann, C. A. , Pennington, B. F. , DeFries, J. C. (2007). Test of alternative hypotheses explaining the comorbidity between attention-deficit/hyperacitivity disorder and conduct disorder. Journal of Abnormal Child Psychology, 36, 29 – 40. First citation in articleCrossref, Google Scholar

  • Rowe, R. , Maughan, B. , Costello, E. J. , Angold, A. (2005). Defining oppositional defiant disorder. Journal of Child Psychology and Psychiatry, 46, 1309 – 1316. First citation in articleCrossref, Google Scholar

  • Rustenbach, S. J. (2003). Metaanalyse–Eine anwendungsorientierte Einführung. Bern: Huber. First citation in articleGoogle Scholar

  • Scheithauer, H. , Mehren, F. , Petermann, F. (2003). Entwicklungsorientierte Prävention von aggressiv-dissozialem Verhalten und Substanzmissbrauch. Kindheit und Entwicklung, 12, 84 – 99. First citation in articleLink, Google Scholar

  • Schmid, M. , Schmeck, K. , Petermann, F. (2008). Persönlichkeitsstörungen im Kindes- und Jugendalter? Kindheit und Entwicklung, 17, 190 – 202. First citation in articleLink, Google Scholar

  • Schmidt, S. , Petermann, F. (2008). Entwicklungspsychopathologie der ADHS. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 56, 265 – 274. First citation in articleLink, Google Scholar

  • Schmidt, S. , Waldmann, H.-C. , Petermann, F. , Brähler, E. (2010). Wie stark sind Erwachsene mit ADHS und komorbiden Störungen in ihrer gesundheitsbezogenen Lebensqualität beeinträchtigt? Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 58, 9 – 21. First citation in articleLink, Google Scholar

  • Shaffer, D. , Fisher, P. , Lucas, C. P. , Duncan, M. K. , Schwab-Stone, M. E. (2000). NIMH Diagnostic Interview Schedule for Children-Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 28 – 38. First citation in articleCrossref, Google Scholar

  • Shankman, S. A. , Lewinsohn, P. M. , Klein, D. N. , Small, J. W. , Seeley, J. R. , Altman, S. E. (2009). Subthreshold conditions as precursors for full syndrome disorders: A 15-year longitudinal study of multiple diagnostic classes. Journal of Child Psychology and Psychiatry, 50, 1485 – 1494. First citation in articleCrossref, Google Scholar

  • Sobanski, E. (2006). Psychiatric comorbidity in adults with attention-deficit/hyperactivity disorder (ADHD). European Archives of Psychiatry and Clinical Neuroscience, 256, i26-i31. First citation in articleCrossref, Google Scholar

  • Steinhausen, H. C. , Novik, T. S. , Baldursson, G. , Curatolo, P. , Lorenzo, M. J. , Rodrigues Pereira, R. et al. (2006). Co-existing psychiatric problems in ADHD in the ADORE cohort. European Child and Adolescent Psychiarty, 15, i25-i29. First citation in articleCrossref, Google Scholar

  • Thapar, A. , Harrington, R. , McGuffin, P. (2001). Examining the comorbidity of ADHD-related behaviours and conduct problems using a twin study design. The British Journal of Psychiatry, 179, 224 – 229. First citation in articleCrossref, Google Scholar

  • Thiels, C. , Schmitz, G. S. (2008). Selbst- und Fremdeinschätzung von Verhaltensauffälligkeiten bei Kindern und Jugendlichen: Zur Validität von Eltern- und Lehrerurteilen. Kindheit und Entwicklung, 17, 118 – 125. First citation in articleLink, Google Scholar

  • Tischler, L. , Schmidt, S. , Petermann, F. , Koglin, U. (2010). ADHS im Jugendalter–Symptomwandel und Konsequenzen für Forschung und klinische Praxis. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 58, 23 – 34. First citation in articleLink, Google Scholar

  • van Lier, P. A. C. , van der Ende, J. , Koot, H. M. , Verhulst, F. C. (2007). Which better predicts conduct problems? The relationship of trajectories of conduct problems with ODD and ADHD symptoms from childhood into adolescence. Journal of Child Psychology and Psychiatry, 48, 601 – 608. First citation in articleCrossref, Google Scholar

  • van Lier, P. A. C. , Crijnen, A. A. (2005). Trajectories of peer-nominated aggression: Risk status, predictors and outcomes. Journal of Abnormal Child Psychology, 33, 99 – 112. First citation in articleCrossref, Google Scholar

  • West, P. , Sweeting, H. , Der, G. , Barton, J. , Lucas, C. (2003). Voice-DISC identified DSM-IV disorders among 15-year-olds in the west of Scotland. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 941 – 949. First citation in articleCrossref, Google Scholar

  • Wolraich, M. L. , Lambert, E. , Bickman, L. , Simmons, T. , Doffing, M. A. , Worley, K. A. (2004). Assessing the impact of parent and teacher agreement on diagnosing attention-deficit hyperactivity disorder. Journal of Developmental and Behavioral Pediatrics, 25, 41 – 47. First citation in articleCrossref, Google Scholar