More than 25% of children and adolescents with obsessive-compulsive disorder had comorbid attention-deficit hyperactivity disorder in a consecutive study of 94 patients, reported Dr. Gabriele Masi and her associates at the Scientific Institute of Child Neurology and Psychiatry in Calambrone, Pisa (Italy).
Overall, 88% of the 24 comorbid patients were male, and the average age of onset of obsessive-compulsive disorder (OCD) was slightly higher among patients with comorbid attention-deficit hyperactivity disorder (ADHD). Several disruptive behavior disorders—oppositional defiant disorder, bipolar disorder, and tic disorder—were significantly more common among comorbid patients.
The 3-year study included 65 males and 29 females aged 8–18 years. All of the patients were undergoing treatment for OCD with selective serotonin reuptake inhibitors, such as fluoxetine and sertraline (Zoloft), but none was being treated for ADHD with psychostimulants (Compr. Psychiatry 2006;47:42–7).
In patients with comorbid ADHD, functional baseline impairment was higher, and improvement in symptoms after 6 months of follow-up was lower. Patients with co-occurring OCD-ADHD were more frequently male (88% vs. 62%). In addition, patients with OCD and ADHD had higher rates of comorbid disorders, such as various anxiety disorders.
There were no significant differences between patients with and without comorbid ADHD with regard to OCD behaviors involving ordering, aggression, contamination, and hoarding.
The study results suggest a need for ADHD screening in all children and adolescents with OCD, the investigators wrote.