Co-Morbid Obsessive–Compulsive Disorder and Attention Deficit Hyperactivity Disorder: Neurobiological Commonalities and Treatment Implications

Cabarkapa, Sonja; King, Joel; Dowling, Nathan; Ng, Chee H.

doi:10.3389/fpsyt.2019.00557

Cited by 16 publications

(13 citation statements)

References 51 publications

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“…(27) There are also concerns that stimulants may induce or exacerbate tics, compulsive behaviors, anxiety, depression or psychotic symptoms. (3,28,29) Hence, individuals with ADHD and these comorbidities may be less likely to receive stimulants and more likely to discontinue or switch treatment. Age, sex, parental psychiatric illness and socioeconomic status have all also been linked to ADHD-treatment initiation, discontinuation and switch, albeit with mixed findings.…”

Section: Introductionmentioning

confidence: 99%

Genetic, Clinical, and Sociodemographic Factors Associated With Stimulant Treatment Outcomes in ADHD

Brikell

Wimberley

Albiñana

et al. 2021

AJP

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Objective: Stimulant-drugs are effective for treating attention-deficit/hyperactivity disorder (ADHD), yet discontinuation and switch to non-stimulant ADHD-drugs is common. This study aimed to identify genetic, clinical and socio-demographic factors influencing stimulant-treatment initiation, discontinuation and switch to non-stimulants in individuals ADHD. Methods:We obtained genetic and national-register data for 9,133 individuals with ADHD from the Danish iPSYCH2012 sample, and defined stimulant-treatment initiation, discontinuation and switch from prescriptions. For each stimulant-treatment outcome, we examined associations with polygenic risk scores (PRSs) for psychiatric disorders, clinical, and socio-demographic factors using survival analyses, and conducted genome-wide association studies (GWASs) and estimated SNP-heritabilities (h 2 SNP).Results: 81% initiated stimulant-treatment. Within two years, 45% discontinued stimulants and 15% switched to non-stimulants. Bipolar-PRS (hazard ratio[HR]=1.05, 95%confidence interval[CI]=1.02-1.09) and schizophrenia-PRS (HR=1.07,95%CI=1.03-1.11) were associated with discontinuation. Depression, bipolar and schizophrenia PRSs were marginally associated with switch (HRrange=1.05-1.07) with CIs including one. No associations were observed for ADHD-PRS and autism-PRS. Individuals diagnosed with ADHD ≥13 years-of-age had higher rates of stimulant initiation, discontinuation, and switch (HRrange=1.27-2.01). Psychiatric comorbidities generally reduced rates of initiation (HRrange=0.84-0.88), and increased rates of discontinuation (HRrange=1.19-1.45) and switch (HRrange=1.40-2.08). Estimated h 2 SNP were not significantly different from zero. No GWAS-hits were identified for stimulant initiation or discontinuation. A locus on chromosome 16q23.3 reached genome-wide significance for switch (p=4.7×10 −8 ). Conclusion:Our findings suggest that individuals with ADHD with higher polygenic liability for mood/psychotic disorders, delayed ADHD diagnosis, and psychiatric comorbidities have higher risk for 4 stimulant-treatment discontinuation and switch to non-stimulants. Despite limited sample size, one possible GWAS-hit for switch was identified, illustrating the potential of utilizing prescription databases in pharmacogenomics.

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Section: Introductionmentioning

confidence: 99%

Genetic, Clinical, and Sociodemographic Factors Associated With Stimulant Treatment Outcomes in ADHD

Brikell

Wimberley

Albiñana

et al. 2021

AJP

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“…About 80% of children with OCD meet diagnostic criteria for other psychological disorders (Langley et al, 2010). OCD is most often comorbid with depressive and anxiety disorder (Peris et al, 2017), tic disorders (Storch et al, 2008), ADHD (Cabarkapa et al, 2019) and, to a lesser extent, externalizing disorders (Guzick et al, 2019). DSM-5 indicates that OCD is also associated "with disorders characterized by impulsivity, such as oppositional defiant disorder" (p.242).…”

Section: Introductionmentioning

confidence: 99%

Irritability, Defiant and Obsessive-Compulsive Problems Development from Childhood to Adolescence

Ezpeleta

Penelo

Navarro

et al. 2021

J Youth Adolescence

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Little is known about the coexistence of oppositionality and obsessive-compulsive problems (OCP) in community children and how it affects their development until adolescence to prevent possible dysfunctions. The co-development of oppositional defiant dimensions and OCP is studied in 563 children (49.7% female) from ages 6 to 13 years, assessed yearly with measures answered by parents and teachers. A 4-class model based on Latent Class Growth Analysis for three parallel processes (irritability, defiant, and OCP) was selected, which showed adequate fitting indexes. Class 1 (n = 349, 62.0%) children scored low on all the measures. Class 2 (n = 53, 9.4%) contained children with high OCP and low irritability and defiant. Class 3 (n = 108, 19.2%) clustered children with high irritability and defiant and low OCP. Class 4 (n = 53, 9.4%) clustered comorbid irritability, defiant, and OCP characteristics. The classes showed different clinical characteristics through development. The developmental co-occurrence of irritability and defiant plus obsessive-compulsive behaviors is frequent and adds severity through development regarding comorbidity, peer problems, executive functioning difficulties, and daily functioning. The identification of different classes when combining oppositional problems and OCP may be informative to prevent developmental dysfunctions and to promote good adjustment through development.

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“…It is one of the most common psychiatric and behavioral disorders in children and adolescents with over 5% of the population affected worldwide and persists in about 60% of the cases into adulthood 2 . ADHD is often accompanied by comorbidities such as conduct or oppositional defiant disorder, major depressive disorder (MDD) 3 , obsessive-compulsive disorder (OCD) 4 , personality disorder 5 , autism spectrum disorder (ASD) 6 , and epilepsy 7 among others. Further, ADHD has also been associated with an increased risk of obesity/overweight 8 .…”

Section: Introductionmentioning

confidence: 99%

The stress–Wnt-signaling axis: a hypothesis for attention-deficit hyperactivity disorder and therapy approaches

et al. 2020

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Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric neurodevelopmental disorders in children and adolescents. Although ADHD has been studied for nearly a century, the cause and pathophysiology of ADHD is yet largely unknown. However, findings from previous studies have resulted in the formation of a new hypothesis: Apart from the well-known multifactorial etiology of ADHD, recent evidence suggests that the interaction between genetic and environmental factors and especially Wnt- and mTOR-signaling pathways might have an important role in the pathophysiology of ADHD. The Wnt-signaling pathway is known to orchestrate cellular proliferation, polarity, and differentiation, and the mTOR pathway is involved in several significant processes of neurodevelopment and synaptic plasticity. As a result, dysregulations of these pathways in a time-dependent manner could lead to neurodevelopmental delays, resulting in ADHD phenotype. This review presents further evidence supporting our hypothesis by combining results from studies on ADHD and Wnt- or mTOR-signaling and the influence of genetics, methylphenidate treatment, Omega-3 supplementation, and stress.

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Co-Morbid Obsessive–Compulsive Disorder and Attention Deficit Hyperactivity Disorder: Neurobiological Commonalities and Treatment Implications

Cited by 16 publications

References 51 publications

Genetic, Clinical, and Sociodemographic Factors Associated With Stimulant Treatment Outcomes in ADHD

Genetic, Clinical, and Sociodemographic Factors Associated With Stimulant Treatment Outcomes in ADHD

Irritability, Defiant and Obsessive-Compulsive Problems Development from Childhood to Adolescence

The stress–Wnt-signaling axis: a hypothesis for attention-deficit hyperactivity disorder and therapy approaches

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