The impact of attention deficit hyperactivity disorder in obsessive-compulsive disorder subjects

Depress Anxiety. 2019 Jun;36(6):533-542. doi: 10.1002/da.22898. Epub 2019 Apr 16.


Background: Recent findings suggest an association between attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). Thus, we evaluated the clinical associated features of ADHD in a large sample of adult OCD patients.

Methods: A cross-sectional study including 955 adult patients with OCD from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinical characteristics in adult OCD patients with and without comorbid ADHD were compared using Fisher's exact test, t-tests or Mann-Whitney tests. Bivariate analyses were followed by logistic regression analysis to identify clinical characteristics independently associated with ADHD comorbidity.

Results: The lifetime prevalence of ADHD in adult OCD patients was 13.7%. The current results indicate that OCD + ADHD patients were more severe, had an earlier onset of the obsessive-compulsive symptoms, a higher history of rheumatic fever, with higher frequencies of sensory phenomena and comorbidity with Tourette syndrome. They also had an increased risk for academic impairment and suicide attempts.

Conclusion: Adult OCD patients with ADHD present some specific clinical features and may represent a special subgroup of adult OCD. Future studies should focus on the development of interventions more tailored to the phenotype of this subgroup of patients.

Keywords: attention deficit disorder with hyperactivity; comorbidity; obsessive-compulsive disorder.

MeSH terms

  • Academic Success
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Attention Deficit Disorder with Hyperactivity / epidemiology*
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Brazil / epidemiology
  • Comorbidity
  • Correlation of Data
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obsessive-Compulsive Disorder / epidemiology*
  • Obsessive-Compulsive Disorder / psychology*
  • Phenotype
  • Prevalence
  • Suicide, Attempted / statistics & numerical data
  • Tourette Syndrome / epidemiology
  • Young Adult