Category: Obsessive Compulsive and Related Disorders
Keywords: OCD (Obsessive Compulsive Disorder) | Attention | Clinical Trial
Presentation Type: Symposium
Background: Attention-deficit/hyperactivity disorder (ADHD) is estimated to occur in one out of every five people with obsessive-compulsive disorder (OCD). Some have proposed, however, that obsessive rumination may strain frontal functioning, resulting in ADHD-like symptoms like executive dysfunction and inattention. The present study evaluated this hypothesis in a pediatric clinical context by examining whether ADHD symptoms decrease following OCD treatment, and whether those changes correspond with treatment outcome.
Methods: Participants were 50 children and adolescents enrolled in a randomized controlled trial investigating combined sertraline-cognitive behavioral treatment for OCD. Obsessive-compulsive and ADHD symptoms were measured before and after treatment using the Children’s Yale-Brown Obsessive-Compulsive Scale and the Swanson, Nolan, and Pelham-IV. Multivariate repeated-measures analysis of variance was used to test whether ADHD symptoms reduce across treatment, and whether these reductions were moderated by degree of OCD improvement.
Results: Improvements in ADHD-inattention symptoms were significantly moderated by treatment response, such that youth who experienced greater improvement in OCD severity also experienced greater improvements in inattention, F(1) = 8.46, p = .006, η2partial = .16. Hyperactivity/impulsivity was not found to significantly decrease across treatment regardless of OCD improvement status. Youth in remission at the end of treatment experienced an average of 30% ADHD symptom reduction, while those not in remission only experienced an 8% reduction in ADHD symptoms.
Conclusion: Among youth with OCD, improvements in attention problems appear to be tied to treatment response, lending preliminary support for the “executive overload” model of OCD in young people with disorder. Clinicians may consider addressing obsessive-compulsive symptoms before assigning an ADHD diagnosis when treating youth with OCD and clinically significant attention problems, particularly when OCD-onset clearly precedes inattention and occurs independently of tics, which have been found to have a genetic link to ADHD and OCD.
University of Florida
Saturday, November 18
8:30 AM – 10:00 AM
Sunday, November 19
8:30 AM – 10:00 AM
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