{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T03:36:58Z","timestamp":1774928218794,"version":"3.50.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T00:00:00Z","timestamp":1620777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Attention deficit hyperactivity disorder (ADHD) is a common disease in childhood and adolescence. In about 60% of pediatric patients, the symptoms persist into adulthood. Treatment guidelines for adult ADHD patients suggest multimodal therapy consisting of psychostimulants and psychotherapy. Many adult ADHD patients also suffer from psychiatric comorbidities, among others obsessive\u2013compulsive disorder (OCD). The treatment of the comorbidity of ADHD and OCD remains challenging as the literature is sparse. Moreover, the impact of psychostimulants on obsessive\u2013compulsive symptoms is still unclear.<\/jats:p><jats:p><jats:bold>Case Presentation:<\/jats:bold> Here, we report on a 33-year-old patient with an OCD who was unable to achieve sufficient remission under long-term guideline-based treatment for OCD. The re-examination of the psychological symptoms revealed the presence of adult ADHD as a comorbid disorder. The patient has already been treated with paroxetine and quetiapine for the OCD. Due to the newly established diagnosis of ADHD, extended-release methylphenidate (ER MPH) was administered in addition to a serotonin reuptake inhibitor. After a dose of 30 mg ER MPH, the patient reported an improvement in both the ADHD and the obsessive\u2013compulsive symptoms. After discharge, the patient reduced ER MPH without consultation with a physician due to subjectively described side effects. The discontinuation of medication led to a renewed increase in ADHD and obsessive\u2013compulsive symptoms. The readjustment to ER MPH in combination with sertraline and quetiapine thereafter led to a significant improvement in the compulsive symptoms again.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The present case shows that in ADHD and comorbid obsessive\u2013compulsive disorder, treatment with psychostimulants can improve the obsessive\u2013compulsive symptoms in addition to the ADHD-specific symptoms. To our knowledge, this is only the second case report describing a treatment with ER MPH for an adult patient with OCD and ADHD comorbidity in the literature. Further research, especially randomized controlled trials, is needed to standardize treatment options.<\/jats:p>","DOI":"10.3389\/fpsyt.2021.649833","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T05:22:58Z","timestamp":1620796978000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Case Report: Treatment of a Comorbid Attention Deficit Hyperactivity Disorder and Obsessive\u2013Compulsive Disorder With Psychostimulants"],"prefix":"10.3389","volume":"12","author":[{"given":"Ezgi","family":"Dogan-Sander","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Strau\u00df","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1007\/s12402-016-0208-3","article-title":"The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys","volume":"9","author":"Fayyad","year":"2017","journal-title":"Atten Defic Hyperact Disord."},{"key":"B2","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2013"},{"key":"B3","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1186\/s12888-017-1463-3","article-title":"Adult ADHD and comorbid disorders: clinical implications of a dimensional approach","volume":"17","author":"Katzman","year":"2017","journal-title":"BMC Psychiatry."},{"key":"B4","first-page":"i26","article-title":"Psychiatric comorbidity in adults with attention-deficit\/hyperactivity disorder (ADHD)","volume-title":"Eur Arch Psychiatry Clin Neurosci.","author":"Sobanski","year":"2006"},{"key":"B5","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1097\/HRP.0000000000000050","article-title":"Comorbidity between attention deficit\/hyperactivity disorder and obsessive-compulsive disorder across the lifespan: a systematic and critical review","volume":"23","author":"Abramovitch","year":"2015","journal-title":"Harv Rev Psychiatry."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1016\/j.biopsych.2006.09.026","article-title":"Further evidence for co-segregation between pediatric obsessive compulsive disorder and attention deficit hyperactivity disorder: a familial risk analysis","volume":"61","author":"Geller","year":"2007","journal-title":"Biol Psychiatry."},{"key":"B7","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/j.biopsych.2006.03.083","article-title":"Examining the relationship between obsessive-compulsive disorder and attention-deficit\/hyperactivity disorder in children and adolescents: a familial risk analysis","volume":"61","author":"Geller","year":"2007","journal-title":"Biol Psychiatry."},{"key":"B8","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1111\/j.1440-1819.2007.01609.x","article-title":"Attention and cognition in patients with obsessive-compulsive disorder","volume":"61","author":"de Geus","year":"2007","journal-title":"Psychiatry Clin Neurosci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1177\/1087054716669228","article-title":"The features of comorbidity of childhood ADHD in patients with obsessive compulsive disorder","volume":"24","author":"\u00c7elebi","year":"2020","journal-title":"J Atten Disord."},{"key":"B10","doi-asserted-by":"publisher","first-page":"557","DOI":"10.3389\/fpsyt.2019.00557","article-title":"Co-morbid obsessive-compulsive disorder and attention deficit hyperactivity disorder: neurobiological commonalities and treatment implications","volume":"10","author":"Cabarkapa","year":"2019","journal-title":"Front Psychiatry."},{"key":"B11","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1080\/j.1440-1614.2005.01591.x","article-title":"Antipsychotic treatment in obsessive-compulsive disorder: a literature review","volume":"39","author":"Keuneman","year":"2005","journal-title":"Aust N Z J Psychiatry."},{"key":"B12","doi-asserted-by":"publisher","first-page":"316","DOI":"10.4103\/1817-1745.199461","article-title":"Methylphenidate-induced obsessive-compulsive symptoms: a case report and review of literature","volume":"11","author":"Jhanda","year":"2016","journal-title":"J Pediatr Neurosci."},{"key":"B13","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/00004583-199802000-00001","article-title":"Methylphenidate-induced obsessive-compulsiveness","volume":"37","author":"Kouris","year":"1998","journal-title":"J Am Acad Child Adolesc Psychiatry."},{"key":"B14","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1017\/s1092852900018885","article-title":"Methylphenidate-induced obsessive-compulsive symptoms in an elderly man","volume":"8","author":"Serby","year":"2003","journal-title":"CNS Spectr."},{"key":"B15","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1177\/1039856216671664","article-title":"Methylphenidate in the treatment of an adolescent female with obsessive-compulsive disorder and attention deficit hyperactivity disorder: a case report","volume":"25","author":"King","year":"2017","journal-title":"Aust Psychiatry."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1177\/0269881109348172","article-title":"Depression, anxiety and obsessive-compulsive symptoms and quality of life in children with attention-deficit hyperactivity disorder (ADHD) during three-month methylphenidate treatment","volume":"24","author":"G\u00fcrkan","year":"2010","journal-title":"J Psychopharmacol."},{"key":"B17","doi-asserted-by":"crossref","DOI":"10.1027\/00542-000","volume-title":"The AMDP System: Manual for Assesment and Documentation of Psychopathology in Psychiatry","author":"Broome","year":"2017"},{"key":"B18","volume-title":"Conners' Adult ADHD Rating Scales (CAARS): Technical Manual","author":"Conners","year":"1999"},{"key":"B19","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1001\/archpsyc.1989.01810110048007","article-title":"The Yale-brown obsessive compulsive scale: I. Development, use, and reliability","volume":"46","author":"Goodman","year":"1989","journal-title":"Arch Gen Psychiatry."},{"key":"B20","first-page":"5","article-title":"Practice guideline for the treatment of patients with obsessive-compulsive disorder","volume":"164","author":"Koran","year":"2007","journal-title":"Am J Psychiatry."},{"key":"B21","doi-asserted-by":"publisher","first-page":"585","DOI":"10.2165\/11587860-000000000-00000","article-title":"Pharmacological management of treatment-resistant obsessive-compulsive disorder","volume":"25","author":"Abudy","year":"2011","journal-title":"CNS Drugs."},{"key":"B22","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1097\/00004583-200201000-00011","article-title":"Attention-deficit\/hyperactivity disorder in children and adolescents with obsessive-compulsive disorder: fact or artifact?","volume":"41","author":"Geller","year":"2002","journal-title":"J Am Acad Child Adolesc Psychiatry."},{"key":"B23","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/s12402-016-0196-3","article-title":"Obsessive-compulsive adults with and without childhood ADHD symptoms","volume":"8","author":"Tan","year":"2016","journal-title":"Atten Defic Hyperact Disord."},{"key":"B24","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s00702-007-0841-2","article-title":"Children and adolescents with obsessive-compulsive disorder and comorbid attention-deficit\/hyperactivity disorder: preliminary results of a prospective follow-up study","volume":"115","author":"Walitza","year":"2008","journal-title":"J Neural Transm."},{"key":"B25","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1016\/S2215-0366(16)30032-3","article-title":"Adult attention-deficit hyperactivity disorder: key conceptual issues","volume":"3","author":"Asherson","year":"2016","journal-title":"Lancet Psychiatry."},{"key":"B26","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s12402-014-0146-x","article-title":"The neurobiological link between OCD and ADHD","volume":"6","author":"Brem","year":"2014","journal-title":"ADHD Atten Def Hyp Disord."},{"key":"B27","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1002\/hbm.21048","article-title":"Disorder-specific dysfunctions in patients with attention-deficit\/hyperactivity disorder compared to patients with obsessive-compulsive disorder during interference inhibition and attention allocation","volume":"32","author":"Rubia","year":"2011","journal-title":"Hum Brain Mapp."},{"key":"B28","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1001\/jamapsychiatry.2016.0700","article-title":"Structural and functional brain abnormalities in attention-deficit\/hyperactivity disorder and obsessive\u2013compulsive disorder: a comparative meta-analysis","volume":"73","author":"Norman","year":"2016","journal-title":"JAMA Psychiatry."},{"key":"B29","first-page":"89","article-title":"Obsessive-compulsive symptoms secondary to methylphenidate treatment","volume":"46","author":"Kotsopoulos","year":"2001","journal-title":"Can J Psychiatry."},{"key":"B30","first-page":"45","article-title":"M\u00e9thylph\u00e9nidate, tics et compulsions","volume":"26","author":"Guegant","year":"2000","journal-title":"Encephale."},{"key":"B31","doi-asserted-by":"publisher","first-page":"21","DOI":"10.5005\/jp-journals-10045-0028","article-title":"Methylphenidate-induced obsessive compulsive disorder in attention deficit hyperactivity disorder","volume":"2","author":"Vishwaraj","year":"2016","journal-title":"J Med Sci."},{"key":"B32","doi-asserted-by":"publisher","first-page":"275","DOI":"10.5455\/bcp.20110904061403","article-title":"Methylphenidate induced obsessive-compulsive symptoms treated with sertraline","volume":"21","author":"Coskun","year":"2011","journal-title":"Klinik Psikofarmakoloji Bulteni."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2021.649833\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T05:23:09Z","timestamp":1620796989000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2021.649833\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,12]]},"references-count":32,"alternative-id":["10.3389\/fpsyt.2021.649833"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2021.649833","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,12]]},"article-number":"649833"}}