Internationales Symposium (S-001-1 bis S-001-4) S-001-1 Internationales Symposium Integrating Neuroscience and Child Psychiatry Vorsitz:
B. Herpertz-Dahlmann, RWTH Aachen, Kinder- und Jugendpsychiatrie und - psychotherapie K. Konrad, Lehr- und Forschungsgebiet Klinische Neuropsychologie RWTH Aachen, Kinderund Jugendpsychiatrie und - psychotherapie
0001 Recent molecular genetic findings in ADHD Johannes Hebebrand, Rheinische Kliniken Essen, Universität Duisburg/Essen, Kinder- und Jugendpsychiatrie und - psychotherapie Friedel, S., Hinney, A., Dempfle, A., Saar, K., Sauer, S. Pre iously, we had reported a genome wide scan for attention-deficit/hyperacti ity disorder (ADHD) in 02 affected sibs of German ancestry; the highest multipoint LOD score of 4.75 was obtained on chromosome 5p (parametric HLOD analysis under a dominant model) harbouring the dopamine transporter gene (DAT ). We genotyped 0 single nucleotide polymorphisms (SNPs) in this candidate gene and its 5´region in 29 families (including the 02 initial families) with 52 affected offspring. We found that: a) SNP rs46 79 was significantly associated with ADHD upon correction for multiple testing (p= 0.0046); b) the global p- alue for association of haplotypes was significant for block two upon correction for all (n= ) tested blocks (p=0.0048); c) within block two we detected a nominal p = 0.0000 4 for one specific marker combination. This CGC haplotype showed relati e risks of .95 and 2.4 for heterozygous and homozygous carriers, respecti ely; d) finally, our linkage data and the genotype-IBD sharing test (GIST) indicated that genetic ariation at the DAT locus explains.
0002 Neuroimaging in ADHD Sarah Durston, University of Utrecht, Child & Adolescent Psychiatry, Niederlande Attention Deficit Hyperacti ity Disorder (ADHD) is a pre alent neuropsychiatric disorder with onset in childhood. Perhaps the best established cogniti e deficit associated with this disorder is problems with cogniti e control, or the ability to flexibly adapt beha ior. This is exemplified by stop- and go no/go-tasks, where performance is often impaired for affected indi iduals. These deficits are associated with atypical patterns of brain acti ation, including decreased acti ity in inferior prefrontal areas that are critical to this ability. This presentation will discuss studies focusing on the neurobiology of ADHD using functional and anatomical MRI approaches. In our pre ious work, we ha e shown that unaffected siblings of subjects with ADHD also display decreases in prefrontal acti ation and cortical gray matter olume. These findings suggest that anatomical and functional MR measures may be suitable as an intermediate phenotype for studies in estigating gene effects in ADHD. We ha e recently used this approach to in estigate the effects of two genes that are implicated in ADHD. Two genes were selected from meta-analyses, and as they ha e regionally specific expression patterns in the brain. The genes were the gene for the dopamine 4-receptor (DRD4) and the gene for the dopamine transporter (DAT ). The DRD4 gene is preferentially expressed in the prefrontal cortex, whereas DAT is preferentially expressed in the striatum. Their influence on MR measures of brain structure and acti ation was in estigated. We showed that the DAT gene preferentially influences caudate olume, whereas the DRD4 gene preferentially influences prefrontal gray matter olume. Furthermore, the DAT gene affected acti ation in the striatum. This demonstrates that some of the genes implicated in ADHD do indeed affect brain struc-
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ture and function, and suggests that by using neuroimaging measures as intermediate phenotypes we may begin to map out the pathways by which genes influence beha ior.
0003 ADHD in adults Jan Buitelaar, University Medical Center, Nijmegen, Niederlande Attention-deficit / hyperacti ity disorder in adults (ADHD) has been established as a rele ant and alid diagnostic entity in general psychiatry in the last decade. The aim of this presentation is re iew data on issues of clinical assessment and treatment planning. ADHD is a de elopmental disorder with impairing symptoms of inattention, disorganisation, hyperacti ity and impulsi ity. ADHD starts in early childhood and persists in about 50 % through the lifespan into adulthood. Pre alence estimates in adulthood range from –5 %. Genetic and neurobiological backgrounds ha e been more clarified in recent years (Castellanos & Tannock, 2002; Castellanos et al., 2002; Zametkin et al., 990). The impact of the disorder is substantial and consists of underachie ement, social problems, accidents, working problems and relationship difficulties. ADHD leads to low selfesteem, more speeding iolations, (dri ing) accidents and higher costs for society. In 75 % of adults with ADHD, there is at least one other disorder and 0-50 % has two or more comorbid conditions, especially learning disablities, mood disorders, anxiety disorders, substance use disorders and personality disorders. As ADHD in adults was not well known and seldom considered by mental health professionals in the past, only the comorbid conditions were diagnosed. Not only ADHD, but beha ior disorders in general tend to persist o er time in a considerable degree, and may result in adult psychopathology like antisocial personality disorders. A group of 42 consecuti e adolescent female admissions to a psychiatric inpatient program for selfdestructi e beha ior and se ere beha ioral disturbances, was studied using structured diagnostic instruments for ADHD and personality disorders. Females with ADHD (27 %) were compared to those without ADHD, regarding number and type of personality disorders. All subjects in the se ere disturbed group of female patients with ADHD had at least one PD diagnosis, and the mean number of PD diagnoses differed significantly from the non-ADHD group (4.5 ersus .59; T=4.450, df= 5, p=.0002). ADHD females were significantly more often diagnosed with paranoid, histrionic, borderline, passi e-aggressi e and dependant PD compared to the non-ADHD females. Recent follow-up data of 208 boys and girls with ADHD and comorbidity ha e shown that 2 % of them were admitted as adults. The most pre alent diagnosis was any personality disorder, half of which antisocial personality disorder. Girls with ADHD had a significantly higher risk to be admitted as adults than boys. Girls with ADHD and conduct problems had a 60 % chance of being admitted as adults, a sixfold increase compared to those without conduct problems (Dalsgaard, Mortensen, Frydenberg, & Thomson, 2002). In clinical practice, impulsi ity and emotional instability is often only accredited to a Borderline PD, generally out of ignorance that these symptoms can also be important signs of ADHD. Females with ADHD may be diagnosed with Borderline PD without considering ADHD as an alternati e or comorbid condition. This diagnostic confusion may ha e important consequences for the treatment of these patients.
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S-001-2 Internationales Symposium Integrating Neuroscience and Child Psychiatry Vorsitz:
F. Poustka, Universität Frankfurt, Kinder- und Jugendpsychiatrie und - psychotherapie J. Buitelaar, University Medical Center, Nijmegen, Niederlande
0004 Comorbidity in ADHD Marina Danckaerts, UZ Gasthuisberg, Child & Adolescent Psychiatry, Leuven, Belgien
0005 Neurophysiology of Tic discorders and ADHD – effects of their comorbidity Tobias Banaschewski, Universität Göttingen, Kinder- und Jugendpsychiatrie und -psychotherapie Epidemiological data show that attention-deficit/hyperacti ity disorder (ADHD) and tic disorder (TD) co-occur significantly more frequently than expected by chance; in TD, about half of the cases also meet criteria for ADHD and tic disorders are seen in about 20 % of children with ADHD. In comorbid children, ADHD-related symptomatology is often more impairing than tics and tic-associated symptoms. Research results concerning psychopathological, neuropsychological, neurophysiological, structural and functional imaging, as well as genetical findings of the comorbid condition in comparison to both pure disorders are summarized. Their nosological implications concerning the pathophysiology of the comorbid condition will be discussed; diagnostical and treatment recommendations are outlined.
0006 Does ADHD treatment alter the developing brain? Kerstin Konrad, Lehr- und Forschungsgebiet Klinische Neuropsychologie RWTH Aachen, Kinder- und Jugendpsychiatrie und - psychotherapie Einleitung: Psychostimulants are the treatment of first choice in children and adolescents with Attention Deficit Hyperacti ity Disorder (ADHD). In addition, recently, a highly selecti e noradrenergic re-uptake inhibitor (Atomoxetine) has become a ailable for the treatment of ADHD, which also effecti ely reduces symptomatology. The wealth of data supporting the short-term efficacy and safety of these drugs in the treatment of children is contrasted by a dearth of data on long-term effects of psychopharmacological treatment on structural and functional brain de elopment. Rodent studies suggest that stimulants may persistently alter the dopaminergic system with long-term effects that extend beyond termination of treatment. Methode: In this talk, longterm effects of ADHD treatment on the structural and functional brain de elopment will be summarized. In particular, neuroimaging studies with children and adolescents with ADHD will be discussed. In addition, preliminary data on non-psychopharmacological treatment effects on the brain, such as beha ioral inter entions and neurofeedback procedures, will be included. Diskussion/Ergebnisse: Finally, clinical implications with regard to treatment protocols and pre ention trials in children at risk for ADHD will be discussed.
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S-001-3 Internationales Symposium Integrating Neuroscience and Child Psychiatry Vorsitz:
J. Hebebrand, Rheinische Kliniken Essen, Universität Duisburg/Essen, Kinder- und Jugendpsychiatrie und - psychotherapie P. Hoekstra, University Medical Center, Child and Adolescent Psych., Groningen, Niederlande
0007 Brain imaging findings in schizophrenia Frank Schneider, RWTH Aachen, Psychiatrie und Psychotherapie Einleitung: Brain imaging has become a tool of great importance for research in neuropsychiatry. It is used to demonstrate structural and functional abnormalities in patients suffering from psychiatric diseases. Functional imaging is able to pro ide new insights into the correlates between brain and beha ior in mental diseases. Methode: Cogniti e and emotional disturbances are core symptoms of schizophrenia. Functional imaging helps us to assess the neural basis of these disturbed emotional and cogniti e processes. To extend our knowledge about the causes and the course of schizophrenia, different samples of schizophrenia patients ha e been in estigated by functional Magnetic Resonance Imaging (fMRI). Studies in ju enile schizophrenics, early-onset patients and other subgroups of schizophrenia patients ha e shown stable characteristic dysfunctions in the cerebral networks underlying emotional processes, such as emotion recognition and emotional experience. Furthermore, functional disturbances of regions modulating the interaction between emotion and cognition could be obser ed during working memory demands. The findings indicate abnormal brain acti ation especially in subcortical (esp. the amygdala) and in prefrontal areas. Diskussion/Ergebnisse: More recently, approaches ha e been made to identify functional changes related to therapeutic inter entions in schizophrenia. The importance of brain imaging for the identification of functional and structural hallmarks of schizophrenia depends ery much upon the ongoing de elopment of the methods of acquisition and analysis of the data. By keeping this in mind, brain imaging can become one of the most important tools for understanding schizophrenia.
0008 Recent neuroanatomic and genetic findings in autism Herman van Engeland, University Medical Center, Child & Adolescent Psychiatry, Utrecht, Niederlande
0009 Neurobiology of autism Fritz Poustka, Universität Frankfurt, Kinder- und Jugendpsychiatrie und - psychotherapie Autism as a per asi e de elopmental disorder co ers a ariety of symptoms (as many se ere disorders) not necessarily related to the core domains of autism as attention deficits, impulsi ity, compulsi ity, aggression, and mental retardation. Thus, gene scans re eal many hot spots on the genome seemingly suggesting rather relati e small genetic effects. Neurobiological research deals with different approaches as studies in neuroanatomy, neuroimaging, neurochemistry, neurophysiology, chromosomal, and molecular biological. A main target of research, namely to perform a comprehensi e etiological basis for understanding autism, is still lacking: – Pre- and perinatal conditions: Autism has a strong correlation to different pre-, peri- and postnatal complications, but it seems clear, that these complications ha e not an etiological function by causing autism. They seem to be related with the se erity of accompanying mental retardation and language delay, but not with the autism core symptoms as such.
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– EEG abnormalities and Seizure Disorders in Autism: The incidence of epileptic seizures in autism is ariable. Studies of ERP in autism again are relati ely rare and are not supporting a strong and unique discriminate effect related to autism. – Neuroanatomy and brain imaging studies: post-mortem studies did not re eal gross morphological abnormalities, but reduced neuronal cell size and increased cell-packing density, blurred white-grey boundary, heterotopic bands of neurons, abnormal neocortical lamination, mal-aligned Purkinje cells, minicolumnar pathology among other anomalies.Functional neuroimaging studies using Positron Emission Tomography (PET), Single Photon Emitting Tomography (SPECT) and Functional Magnetic Resonance Imaging (fMRT) show pattern of abnormalities in cerebral blood flow, metabolism or in the case of the fMRI weakend entral temporal acti ation in face processing tasks. Pet studies show lower glucose metabolism in the temporal and parietal lobes and other parts of the brain (thalamus, cingulated gyrus), or altered asymmetry. The results are not always consistent. Reduced acti ation in the fMRI studies in face processing of indi iduals with autism (in contrast to object processing) has been recapitulated in se eral studies. Our own studies show no amelioration of face processing acti ation in fMRI after training quite successfully face recognition. Difficulties of situation-rele ant gaze fixation is related to the se erity of lacking social competence. – Neurochemistry: especially hyperserotonemia shows a familial pattern and was found consistently in o er 25 % of children and adolescents with autism. The role of the neurotransmitter serotonin in autism was studied in urine, serum, plasma platelets, cerebrospinal fluid concentrations as with the serotonin precursor tryptophan and tryptophan depletion and also in brainimaging studies. This findings were contradicted by the failing efforts to relate this findings in candidate moleculargenetic studies. Other studies on dopamine, opoid peptides, adrenergic function and others were not fruitful to enlighten our understanding a biological basis of autism. – Studies on chromosomal aberrations ha e also led to some moleculargenetic in estigation, which failed to establish a biological basis of non-syndromal autism. – First MRI studies re eal lack of mirror neurons in the autistic brain. Contemporarily, the main issue of key research in etiology of autism is probably twofold: Firstly to clarify lack of cerebral connecti ity in arious domains ( isual, acoustic, motoric) and secondly of the genetic of migration and differentiation of neurons during early cerebral de elopment.
S-001-4 Internationales Symposium Integrating Neuroscience and Child Psychiatry Vorsitz:
H. van Engeland, University Medical Center, Child & Adolescent Psychiatry, Utrecht, Niederlande T. Banaschewski, ZI für Seelische Gesundheit Mannheim, Kinder- und Jugendpsychiatrie
0010 Neurophysiology of autism Chantal Kemner, University Medical Center, Utrecht, Niederlande
0011 Neurobiology and neuroimmunology of Tourette Syndrome Pieter Hoekstra, University Medical Center, Child and Adolescent Psych., Groningen, Niederlande
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Schwerpunktsymposium (S-002) S-002
Schwerpunktsymposium Zentrales ADHS-Netz
Vorsitz:
M. Döpfner, Universität zu Köln, Kinder- und Jugendpsychiatrie und - psychotherapie F. Resch, Universität Heidelberg, Kinder- und Jugendpsychiatrie und - psychotherapie
0012 Epidemiologie zu ADHS in Deutschland Michael Huss, Charité Berlin, CVK, Kinder- und Jugendpsychiatrie und - psychotherapie Einleitung: Die Aufmerksamkeits-Defizit-Hyperakti itäts-Störung (ADHS) gilt als die häufigste kinder- und jugendpsychiatrische Störung. Die überwiegend aus dem anglo-amerikanischen Sprachraum stammenden Prä alenzangaben schwanken jedoch erheblich. Die Mehrzahl der Schätzwerte liegt im Bereich on 4 bis 0 Prozent (Maximum: 26 %). Deutsche Prä alenzzahlen mit hinreichender epidemiologischer Absicherung liegen bislang nicht or. Methode: Im Rahmen des Pretest für den Kinder- und Jugendsur ey (www.kiggs.de) wurde bei einer repräsentati en Stichprobe on . 64 Kindern und Jugendlichen ein strukturiertes Inter iew, ein dimensionales Verfahren (Eltern-SDQ) sowie eine Verhaltensbeobachtung on trainierten Untersuchern durchgeführt. Die Ergebnisse wurden mit einer Klinikstichprobe on .22 Kindern und Jugendlichen erglichen. Diskussion/Ergebnisse: Auf der Grundlage der Prestest-Daten wird ein Algorithmus für eine erste bundesweite Prä alenzschätzung im Rahmen des Hauptsur eys entwickelt (Huss 2004). In den Algorithmus gehen folgende Parameter ein: ) Anteil der gemäß der SDQ-Kriterien auffälligen Kinder 2) Anteil mit Auswirkung auf das psychosoziale Funktionsni eau ) Anteil mit hinreichender Zeitdauer der Symptome 4) Anteil mit tatsächlicher Diagnose (positi er prädikti er Wert) 5) Anteil der nicht identifizierten Betroffenen ( -Sensiti ität). Unter Zugrundelegung des Algorithmus ergibt sich ein oberer Schätzwert on ,9 % betroffener Kinder und Jugendlicher in Deutschland. Einflussfaktoren auf den Schätzwert (Klassifikationssystem; Verteilungseigenschaften der Skalen; Impact) werden diskutiert.
0013 Causal pathways of ADHD Edmund Sonuga-Barke, University of Southampton, Vereinigtes Königreich Until recently, causal models of attention-deficit hyperacti ity disorder (ADHD) ha e typically tended to focus on the role of single, simple core deficits in the pathogenesis of this condition. One such model highlights the role of executi e dysfunction due to deficient inhibitory control resulting from disturbances in the frontodorsal striatal circuit and associated mesocortical dopaminergic branches. An alternati e to this presents ADHD as resulting from impaired signaling of delayed rewards arising from disturbances in moti ational processes, in ol ing fronto entral striatal reward circuits and mesolimbic branches terminating in the entral striatum, particularly the nucleus accumbens. While traditionally regarded as competing, emerging data suggest that different simple deficit models of ADHD may in fact represent complimentary causal pathways. This pro ides a strong impetus for a theoretical model of ADHD that considers multiple pathways of dysregulation. The recognition of neuropathological heterogeneity in ADHD is likely to ha e important implications for the clinical management of this condition, potentially impacting on both diagnostic strategies and treatment options.
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Biography: Edmund Sonuga-Barke is Professor of De elopmental Psychopathology at the Uni ersity of Southampton and Director of the De elopmental Brain-Beha iour Unit. His research efforts are focused on translating de eloping knowledge about the genetic and en ironmental origins of ADHD and their neuro-biological and cogniti e mediators into effecti e e idence-based management approaches. He currently holds isiting chairs at the Institute of Psychiatry, King’s College, and New York Uni ersity and is an editor of the Journal of Child Psychology & Psychiatry. He is on the joint WHO, NIH and APA workgroup for externalising disorders and the DSM-V taskforce for externalising disorders and learning disabilities.
0014 Early environmental risk factors of ADHD Jan Buitelaar, University Medical Center, Nijmegen, Niederlande Attention-deficit hyperacti ity disorder (ADHD) is a disorder of inattention, impulsi ity, and hyperacti ity with onset in preschool age in about 50 % of the cases. Twin and adoption studies show ADHD to be highly heritable, and molecular-genetic studies indicate the in ol ement of se eral susceptibility genes as DRD4, DRD5, DAT , and the noradrenaline and serotonin transporter genes. Pregnancy and deli ery complications raise the risk for ADHD. Specific complications implicated include toxaemia or eclampsia, poor maternal health, maternal age, long duration of labour, fetal distress, and antepartum haemorrhage. Low birthweight is a risk factor for ADHD, with birth weight lower than 2500 increasing the risk about twofold, and birth weight lower than 500 g increasing the risk e en more. The effect of low birth weight seems to be independent from that of potential confounders such as prenatal exposure to alcohol and cigarettes, and genetic risk for ADHD. There is abundant e idence that prenatal exposure of the fetus to nicotine an en ironmental risk is for ADHD and related externalizing beha ior problems in later de elopment, e en when controlled for potential confounders such as genetic risk for ADHD. Prenatal exposure to maternal alcohol use leads to beha ioural, cogniti e, and learning problems that could present as ADHD, but the e idence across studies is less consistent when compared to nicotine exposure. Similar considerations apply to prenatal stress during pregnancy, where contradictory findings are reported but o erall data suggest a possible modest contribution to ADHD symptoms in the offspring. Biosketch Jan Buitelaar is a child psychiatrist and Professor of General Psychiatry and Child and Adolescent Psychiatry at Radboud Uni ersity Nijmegen Medical Center in Nijmegen, The Netherlands. His research interests include neuropsychiatric disorders in children, adolescents and adults such as autism, ADHD, and conduct disorder. He is in ol ed in a number of psychopharmacological, psychophysiological, neuroimaging, epidemiological, and genetic studies in these disorders. He is chief editor of European Child and Adolescent Psychiatry.
0015 European Guidelines on the Treatment of ADHD Eric Taylor, Institut of Psychiatry, Child & Adolescent Psychiatry, London, Vereinigtes Königreich The treatment and recognition of ADHD remain contro ersial in spite of a great deal of research, and different European countries are taking different lines with regard to the linked issues of diagnosis and medication. A multinational group of experienced academic clinicians and clinical researchers with special interests in the hyperkinetic disorders was therefore identified through the European Network for Hyperkinetic Disorders (EUNETHYDIS); and they ha e produced a succession of guideline recommendations; most recently, on the use of longer-acting medications. Diagnosis usually requires information from different sources, and beha ioural information or obser ation is usually more reliable than self-report. A wide ariety of parent and teacher rating scales is a ailable for screening purposes. Questionnaires are not sufficient for indi idual diagnosis; they rely upon the respondents’ judgement of what le el of symptomatology constitutes a problem and tend to o erestimate beha ioural problems. Structured inter iewing of parents has the ad antage o er questionnaires that possible ambiguity o er symptom content and se erity may be o ercome by establishing better rapport between the respondent’s and the inter iewer’s concepts of disturbed beha iour. In ad-
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dition they allow documentation of the context, age of onset and chronicity of the problems. Obser ations of the child’s beha iour are especially aluable in younger children. It may be possible to witness directly the o eracti ity, the disinclination to wait and the choice of immediate rather than delayed gratification. Diagnostic assessment needs to go beyond the recognition of the core symptoms and establish the presence or absence of associated features (such as mood instability), complications (such as conduct and oppositional disorders) and conditions that can both accompany and simulate ADHD (such as autism and Tourette disorder). Psychological inter entions, including ad ice, beha iour therapy and self-instruction are widely applicable and will be sufficient in some cases. There is not, howe er, a sound e idence base for inter entions such as family therapy or dynamic psychotherapy. Medication should be a ailable for selected cases, and ser ices should pro ide expertise in their use. Stimulant actions correlate closely with inhibition of the dopamine transporter (indexed by labelled raclopride in PET). Atomoxetine inhibits noradrenaline transport and may therefore increase dopamine le els in frontal regions but not striatal. Doses of stimulants are quite ariable and titration against monitored response is desirable. A range of second-line drugs is a ailable in specialist practice, including modafinil, tricyclic and certain other antidepressants, and nicotine. Long-acting medication is increasingly a ailable in Europe. A systematic re iew of published and unpublished data on the use of long-acting medications in ADHD and hyperkinetic disorder was undertaken, gi ing effect sizes and numbers-to-treat for extended-release stimulant preparations and atomoxetine. The conclusions included: ( ) Long-acting preparations should be a ailable and used; (2) They should not replace short-acting drugs (which will be the initial treatment for many children for reasons of cost and flexibility of dosing). Indi idual clinical choice is needed. ( ) Both atomoxetine and extended-release preparations of stimulants should be a ailable. The choice will depend upon the circumstances, and detailed recommendations are made. Long-term treatment is increasingly undertaken. People diagnosed as children often continue symptoms into adult life. Randomised controlled trials show that stimulants and atomoxetine are superior to placebo in reducing core symptoms of hyperacti ity in adults. Metaanalysis shows similar effect sizes to that seen in child and adolescent samples. Clinical experience suggests that some will benefit also in o erall social adjustment. Ne ertheless, medication in adult life is rare and contro ersial. Most drug treatments are not licensed for use for adults in any European country – though this situation may well change in the future. Atomoxetine is licensed for use in adults but only when treatment was initiated in childhood or adolescence.
0016 ADHD: treatment guidelines in clinical practice Marina Danckaerts, UZ Gasthuisberg, Child & Adolescent Psychiatry, Leuven, Belgien O er the past years both European and American guidelines on diagnosis and treatment of ADHD ha e been updated. These publications are intended to literally guide clinicians in their daily decision making process, so that each indi idual child may profit from the best e idence a ailable for it’s care. Yet, for so many children, decisions, different from those proposed by the guidelines are taken. In this talk the building stones for a clinical decision making process and the factors di erting clinical decisions away from existing guidelines are outlined. Are there clinical situations in which the best e idence a ailable is not in the best interest of the indi idual child?
0017 Therapie von ADHS bei Erwachsenen Michael Rösler, Universität des Saarlandes Homburg, Neurozentrum IGPUP
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0018 Das zentrale ADHS-Netz: Aufgaben und Perspektiven in der Therapie von Kindern, Jugendlichen und Erwachsenen Manfred Döpfner, Universität zu Köln, Kinder- und Jugendpsychiatrie und - psychotherapie Krause, J. Das zentrale adhs-netz ist ein bundesweites interdisziplinäres Netzwerk zur Verbesserung der Versorgung on Kindern, Jugendlichen und Erwachsenen mit Aufmerksamkeitsdefizit-/ Hyperakti itätsstörung (ADHS). Das Netzwerk richtet sich sowohl an Experten als auch an Betroffene, ihre Angehörigen und Bezugspersonen. Es informiert außerdem die Öffentlichkeit über ADHS. Im Auftrag des Bundesministeriums für Gesundheit möchte das zentrale adhs-netz ein umfassendes Gesundheitsmanagement für Menschen mit ADHS fördern. Die Leitungsgruppe ist interdisziplinär besetzt und besteht aus ier Mitgliedern aus den Fachbereichen der Kinder- und Jugendpsychiatrie und -psychotherapie, der Kinder- und Jugendmedizin, der Psychiatrie und Psychotherapie. Im zentralen adhs-netz sind rund 0 regionale Netze zusammen geschlossen, die or Ort an der Verbesserung der Versorgung on Kindern, Jugendlichen und Erwachsenen mit ADHS arbeiten. In dem Vortrag werden Schwachstellen in der aktuellen Versorgung dieser Gruppe aufgezeigt und die Möglichkeiten der Verbesserung dieser Situation diskutiert.
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