A prospective investigation of impacts of comorbid attention deficit hyperactivity disorder (ADHD) on clinical features and long-term treatment response in adult patients with obsessive-compulsive disorder (OCD)

Background: A close association between obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) in children and adolescents has been investigated in previous studies. However, few studies examined the relationship between lifetime comorbidity of ADHD and OCD in adults...

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Main Authors: Masahiro Miyauchi, Naomi Matsuura, Keiichiro Mukai, Takuya Hashimoto, Shun Ogino, Kyosuke Yamanishi, Hisashi Yamada, Kazuhisa Hayashida, Hisato Matsunaga
Format: Article
Language:English
Published: Elsevier 2023-08-01
Series:Comprehensive Psychiatry
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0010440X2300038X
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author Masahiro Miyauchi
Naomi Matsuura
Keiichiro Mukai
Takuya Hashimoto
Shun Ogino
Kyosuke Yamanishi
Hisashi Yamada
Kazuhisa Hayashida
Hisato Matsunaga
author_facet Masahiro Miyauchi
Naomi Matsuura
Keiichiro Mukai
Takuya Hashimoto
Shun Ogino
Kyosuke Yamanishi
Hisashi Yamada
Kazuhisa Hayashida
Hisato Matsunaga
author_sort Masahiro Miyauchi
collection DOAJ
description Background: A close association between obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) in children and adolescents has been investigated in previous studies. However, few studies examined the relationship between lifetime comorbidity of ADHD and OCD in adults. Therefore, we sought to investigate the clinical and psychopathological features related to comorbid ADHD in Japanese adult patients with OCD. Methods: We assessed lifetime comorbidity of ADHD in 93 adult Japanese patients with OCD. Additionally, we used the Japanese version of Conners' Adult ADHD Rating Scales to assess the characteristics and severity of ADHD in each participant. According to the results, we excluded OCD patients that did not have ADHD but who exhibited elevated levels of ADHD traits. We compared OCD patients with ADHD (ADHD+ group) and those without ADHD or its trait (ADHD− group) in terms of background profiles and clinical features, such as OCD symptomatology and psychometric test results. Additionally, the 6-month treatment outcome was compared prospectively between groups. Results: Of the 93 OCD participants, the prevalence of lifetime comorbidity of ADHD was estimated as 16.1%. Compared with the ADHD− group, participants in the ADHD+ group had an earlier age of onset of OCD, higher frequencies of hoarding symptoms, higher levels of depressive and anxiety symptoms and lower quality of life, more elevated levels of impulsivity, and higher rates of substance or behavioral addiction and major depression. Finally, the mean improvement rate on the Yale-Brown Obsessive Compulsive Scale after 6 months of standardized OCD treatment in the ADHD+ group (16.1%) was significantly lower than that in the ADHD− group (44.6%). Conclusion: The lifetime comorbidity of ADHD is likely to exert a significant effect on clinical features and treatment outcome in adult patients with OCD. It is important to consider that underlying ADHD pathology may function as a facilitator for increased severity of global clinical features and treatment refractory conditions in OCD patients. Further studies are required to examine treatment strategies for such patients.
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spelling doaj.art-5fa18a8bf98f4b539592451c526df86b2023-07-23T04:53:29ZengElsevierComprehensive Psychiatry0010-440X2023-08-01125152401A prospective investigation of impacts of comorbid attention deficit hyperactivity disorder (ADHD) on clinical features and long-term treatment response in adult patients with obsessive-compulsive disorder (OCD)Masahiro Miyauchi0Naomi Matsuura1Keiichiro Mukai2Takuya Hashimoto3Shun Ogino4Kyosuke Yamanishi5Hisashi Yamada6Kazuhisa Hayashida7Hisato Matsunaga8Department of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, JapanGraduate School of Education, Mie University, Mie, JapanDepartment of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, JapanDepartment of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, JapanDepartment of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, JapanDepartment of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, JapanDepartment of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, JapanDepartment of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, JapanDepartment of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, Japan; Corresponding author at: Department of Neuropsychiatry, Hyogo Medical University, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.Background: A close association between obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) in children and adolescents has been investigated in previous studies. However, few studies examined the relationship between lifetime comorbidity of ADHD and OCD in adults. Therefore, we sought to investigate the clinical and psychopathological features related to comorbid ADHD in Japanese adult patients with OCD. Methods: We assessed lifetime comorbidity of ADHD in 93 adult Japanese patients with OCD. Additionally, we used the Japanese version of Conners' Adult ADHD Rating Scales to assess the characteristics and severity of ADHD in each participant. According to the results, we excluded OCD patients that did not have ADHD but who exhibited elevated levels of ADHD traits. We compared OCD patients with ADHD (ADHD+ group) and those without ADHD or its trait (ADHD− group) in terms of background profiles and clinical features, such as OCD symptomatology and psychometric test results. Additionally, the 6-month treatment outcome was compared prospectively between groups. Results: Of the 93 OCD participants, the prevalence of lifetime comorbidity of ADHD was estimated as 16.1%. Compared with the ADHD− group, participants in the ADHD+ group had an earlier age of onset of OCD, higher frequencies of hoarding symptoms, higher levels of depressive and anxiety symptoms and lower quality of life, more elevated levels of impulsivity, and higher rates of substance or behavioral addiction and major depression. Finally, the mean improvement rate on the Yale-Brown Obsessive Compulsive Scale after 6 months of standardized OCD treatment in the ADHD+ group (16.1%) was significantly lower than that in the ADHD− group (44.6%). Conclusion: The lifetime comorbidity of ADHD is likely to exert a significant effect on clinical features and treatment outcome in adult patients with OCD. It is important to consider that underlying ADHD pathology may function as a facilitator for increased severity of global clinical features and treatment refractory conditions in OCD patients. Further studies are required to examine treatment strategies for such patients.http://www.sciencedirect.com/science/article/pii/S0010440X2300038XObsessive-compulsive disorderAttention-deficit/hyperactivity disorderComorbidityHoardingTreatment-refractoriness
spellingShingle Masahiro Miyauchi
Naomi Matsuura
Keiichiro Mukai
Takuya Hashimoto
Shun Ogino
Kyosuke Yamanishi
Hisashi Yamada
Kazuhisa Hayashida
Hisato Matsunaga
A prospective investigation of impacts of comorbid attention deficit hyperactivity disorder (ADHD) on clinical features and long-term treatment response in adult patients with obsessive-compulsive disorder (OCD)
Comprehensive Psychiatry
Obsessive-compulsive disorder
Attention-deficit/hyperactivity disorder
Comorbidity
Hoarding
Treatment-refractoriness
title A prospective investigation of impacts of comorbid attention deficit hyperactivity disorder (ADHD) on clinical features and long-term treatment response in adult patients with obsessive-compulsive disorder (OCD)
title_full A prospective investigation of impacts of comorbid attention deficit hyperactivity disorder (ADHD) on clinical features and long-term treatment response in adult patients with obsessive-compulsive disorder (OCD)
title_fullStr A prospective investigation of impacts of comorbid attention deficit hyperactivity disorder (ADHD) on clinical features and long-term treatment response in adult patients with obsessive-compulsive disorder (OCD)
title_full_unstemmed A prospective investigation of impacts of comorbid attention deficit hyperactivity disorder (ADHD) on clinical features and long-term treatment response in adult patients with obsessive-compulsive disorder (OCD)
title_short A prospective investigation of impacts of comorbid attention deficit hyperactivity disorder (ADHD) on clinical features and long-term treatment response in adult patients with obsessive-compulsive disorder (OCD)
title_sort prospective investigation of impacts of comorbid attention deficit hyperactivity disorder adhd on clinical features and long term treatment response in adult patients with obsessive compulsive disorder ocd
topic Obsessive-compulsive disorder
Attention-deficit/hyperactivity disorder
Comorbidity
Hoarding
Treatment-refractoriness
url http://www.sciencedirect.com/science/article/pii/S0010440X2300038X
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