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Misdiagnosis of ADHD in Individuals Diagnosed With Obsessive-Compulsive Disorder: Guidelines for Practitioners

  • Anxiety, Obsessive Compulsive, and Related Disorders (B Brennan and D Dougherty, Section Editors)
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Opinion statement

Attention deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) are reported to frequently co-occur, particularly in children. However, recent research undermines the viability of such comorbidity. Research further suggests that OCD is associated with deficient cognitive functioning, particularly in the domain of executive function. This may be the underlying reason for the high co-occurrence rates of ADHD reported in OCD samples, compared to the relatively low rates of OCD reported in ADHD samples. Furthermore, a contrasting neurobiological, phenomenological, pharmacological, and psychotherapeutic profile between the two disorders further challenges the viability of a genuine comorbidity. In addition, there is a lack of a solid etiological account for such comorbidity—which may be to a large extent mediated by the presence of tic disorders. The consequences of misdiagnosis of OCD as ADHD in children may be dire because of the putative negative impact of stimulant medications on OCD symptoms. It is recommended that clinicians exercise vigilance when facing a potential dual diagnosis of ADHD and OCD. In order to determine whether OCD is the primary disorder clinicians should inquire about the possibility of a background tic disorder, assess compulsive rituals, impulsivity, risk taking, and the level of distress associated with intrusive thoughts. Once OCD has been determined as the primary condition, inattention and executive dysfunction should be carefully considered as an epiphenomenon of obsessive-compulsive symptoms.

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  1. Department of Psychology, Texas State University, UAC 253, San Marcos, TX, 78666, USA

    Amitai Abramovitch

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Abramovitch, A. Misdiagnosis of ADHD in Individuals Diagnosed With Obsessive-Compulsive Disorder: Guidelines for Practitioners. Curr Treat Options Psych 3, 225–234 (2016). https://doi.org/10.1007/s40501-016-0084-7

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