How OCD and ADHD Similarities Can Cause Misdiagnosis

Table of ContentsView AllTable of ContentsOverview of OCD and ADHDSimilaritiesDifferencesCausesMisdiagnosisTreatment

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Overview of OCD and ADHD

Similarities

Differences

Causes

Misdiagnosis

Treatment

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Obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) are distinct conditions, but they do share some similar symptoms and may even occur together at the same time. This can create complications when it comes to diagnosis and treatment.

OCD and ADHD affect similar regions of the brain and have effects on functioning and relationships. Both OCD and ADHD can make it challenging for people to pay attention, which can interfere with a person’s ability to function in areas such as work and school.

However, there are important differences that help distinguish the two conditions. For example, while people with ADHD often struggle with impulsivity, those with OCD tend to overthink and avoid risk-taking.

At a GlanceBecause there is some overlap in the symptoms of OCD and ADHD, it can contribute to the misdiagnosis of these conditions. That’s why it is important to talk to a doctor or mental health professional about what you are experiencing so they can get the full picture in order to make an accurate diagnosis and provide effective treatments. Keep reading to learn more about how OCD and ADHD overlap, key differences between the two conditions, and how misdiagnosis can complicate treatment.

At a Glance

Because there is some overlap in the symptoms of OCD and ADHD, it can contribute to the misdiagnosis of these conditions. That’s why it is important to talk to a doctor or mental health professional about what you are experiencing so they can get the full picture in order to make an accurate diagnosis and provide effective treatments. Keep reading to learn more about how OCD and ADHD overlap, key differences between the two conditions, and how misdiagnosis can complicate treatment.

It is pretty common knowledge thatOCDcoexists with several other disorders, including other anxiety disorders and major depressive disorder (MDD). Many also recognize there are crossover symptoms of OCD-like behavior and several other disorders.

Autism spectrum disorders and ADHD are among those.Some research also suggests that there is an overlap of ADHD and OCD among people who engage in hoarding behaviors.

Estimates suggest that around 12% of people with OCD also have ADHD. Among children with OCD, around 25.5% also have ADHD.

OCDRisk avoidanceInternalizing behaviorsSymptoms increase due to stressADHDRisk toleranceExternalizing behaviorsSymptoms change with age

OCDRisk avoidanceInternalizing behaviorsSymptoms increase due to stress

Risk avoidance

Internalizing behaviors

Symptoms increase due to stress

ADHDRisk toleranceExternalizing behaviorsSymptoms change with age

Risk tolerance

Externalizing behaviors

Symptoms change with age

Similarities Between OCD and ADHD

To understand how OCD and ADHD are sometimes misdiagnosed, it can be helpful to look at the similarities between the two conditions. While they seem very different, the overlapping symptoms and effects can create challenges.

Key Differences Between OCD and ADHD

While there are some similarities between the two conditions, there are also important differences that help tell them apart.

What Causes OCD and ADHD?

People with the inattentive type of ADHD are often distracted, disorganized, daydreamy, and forgetful. Again, not your stereotypical OCD traits. Those who have thecombined type of ADHD(about 70%) have symptoms of both.

OCD and ADHD Misdiagnosis

These two disorders often get confused when achild(or adult in a work setting) with OCD has trouble in school. After all, ADHD, which causes problems withexecutive functioning(organization, planning, reasoning, prioritizing, executing projects, following through with work, etc.), creates challenges in the classroom.

How OCD Can Mimic ADHD

Children with OCD who spend a lot of time ordering, arranging, or checking their books, supplies, and handwriting may appear to be having problems with executive functions when they are simply trying to get or keep things on the desk in the proper place. Understanding what motivates the child’s (or adult’s) behavior is key to a proper diagnosis.

How ADHD Can Mimic OCD

ADHD can result in OCD-like coping skills. A child or adult who has trouble getting organized or who is easily distracted may spend an inordinate amount of time arranging, ordering, and cleaning things. Sometimes, that isprocrastination, a typical ADHD trait, but it may be an ADHD coping skill.

Distinctions Between OCD and ADHD

With regard to proper diagnosis, it is important to remember that ADHD is present across all domains; OCD is generally very specific with regard to obsessive thoughts and compulsive behaviors. It is also worth noting that not all people with OCD have the type related to fear of germs and cleaning. In fact, most do not have spotless homes or lockers.

Although ADHD was once believed to affect only children, the research has finally caught up with reality; in 2013, the DSM-5 moved ADHD from the category of “Disorders Usually Diagnosed in Infancy, Childhood, or Adolescence” to that of “Neurodevelopmental Disorder” recognizing that many continue to have symptoms into adulthood.

It was once believed to largely disappear after puberty. Today, experts recognize that while ADHD characteristicschange as people age, it is a lifelong form of neurodivergence.

Treatment for OCD and ADHD

About 30% of people with ADHD have co-occurring anxiety disorders, including OCD.Those who have problems with low dopamine and/or norepinephrine and high levels of serotonin may indeed have both OCD and ADHD. In these cases, it is extremely important to treat both disorders. However, doing so requires skill and patience.

Research also suggests that co-occurring OCD and ADHD is associated with an earlier onset of OCD symptoms.

Prescribers often treat the symptoms that are causing the most problems first. When both conditions are present, researchers recommend treating OCD first before addressing ADHD.

The treatment for OCD with selective-serotonin reuptake inhibitors (SSRIs) is not usually contraindicated in ADHD, and some estimate up to 50% of people with ADHD also have depression).

However, stimulant medications used to treat ADHD can exacerbateOCD symptomswith very serious outcomes. This includes the worsening of OCD symptoms.For those with both disorders, there are non-stimulant medications for ADHD that may have less impact on OCD symptoms.

Treatment for both OCD and ADHD typically includes medication management,therapy, and self-help.

Keep in Mind

While it isn’t common for OCD and ADHD to occur together, it can happen. The two conditions also share some overlapping characteristics, which can sometimes make diagnosis more challenging. If you suspect you have OCD, ADHD, or both, talk to your doctor for further evaluation. Your healthcare provider can assess your symptoms, make a diagnosis, and recommend treatments that can help.

17 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.International OCD Foundation.Who gets OCD?Brem S, Grünblatt E, Drechsler R, Riederer P, Walitza S.The neurobiological link between OCD and ADHD.Atten Defic Hyperact Disord. 2014;6(3):175-202. doi:10.1007/s12402-014-0146-xPark JM, Samuels JF, Grados MA, et al.ADHD and executive functioning deficits in OCD youths who hoard.Journal of Psychiatric Research. 2016;82:141-148. doi:10.1016/j.jpsychires.2016.07.024Cabarkapa S, King JA, Dowling N, Ng CH.Co-morbid obsessive-compulsive disorder and attention deficit hyperactivity disorder: Neurobiological commonalities and treatment implications.Front Psychiatry. 2019;10:557. doi:10.3389/fpsyt.2019.00557Norman LJ, Carlisi C, Lukito S, et al.Structural and functional brain abnormalities in attention-deficit/hyperactivity disorder and obsessive-compulsive disorder: A comparative meta-analysis.JAMA Psychiatry.2016;73(8):815–825. doi:10.1001/jamapsychiatry.2016.0700Kedem S, Yust-Katz S, Carter D, et al.Attention deficit hyperactivity disorder and gastrointestinal morbidity in a large cohort of young adults.World J Gastroenterol. 2020;26(42):6626-6637. doi: 10.3748/wjg.v26.i42.6626van Lieshout M, Luman M, Twisk JW, et al.A 6-year follow-up of a large European cohort of children with attention-deficit/hyperactivity disorder-combined subtype: outcomes in late adolescence and young adulthood.Eur Child Adolesc Psychiatry. 2016;25(9):1007-1017. doi:10.1007/s00787-016-0820-ySinopoli VM, Burton CL, Kronenberg S, Arnold PD.A review of the role of serotonin system genes in obsessive-compulsive disorder.Neurosci Biobehav Rev. 2017;80:372‐381. doi:10.1016/j.neubiorev.2017.05.029Salvi V, Migliarese G, Venturi V, et al.ADHD in adults: clinical subtypes and associated characteristics. Riv Psichiatr. 2019;54(2):84-89. doi:10.1708/3142.31249Abramovitch A.Misdiagnosis of ADHD in individuals diagnosed with obsessive-compulsive disorder: Guidelines for practitioners.Curr Treat Options Psych. 2016;3(3):225-234. doi:10.1007/s40501-016-0084-7Mahone EM, Denckla MB.Attention-Deficit/Hyperactivity Disorder: A Historical Neuropsychological Perspective. J Int Neuropsychol Soc. 2017;23(9-10):916-929. doi:10.1017/S1355617717000807Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).Coexisting conditions.Mersin Kilic S, Dondu A, Memis CO, Ozdemiroglu F, Sevincok L.The clinical characteristics of adhd and obsessive-compulsive disorder comorbidity.J Atten Disord. 2020;24(12):1757-1763. doi:10.1177/1087054716669226Guzick AG, McNamara JPH, Reid AM, et al.The link between ADHD-like inattention and obsessions and compulsions during treatment of youth with OCD.J Obsessive Compuls Relat Disord. 2017;12:1-8. doi: 10.1016/j.jocrd.2016.11.004Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ.Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017;17(1):302. doi:10.1186/s12888-017-1463-3Cabarkapa S, King JA, Dowling N, Ng CH.Co-morbid obsessive-compulsive disorder and attention deficit hyperactivity disorder: Neurobiological commonalities and treatment implications.Front Psychiatry. 2019;10:557. doi:10.3389/fpsyt.2019.00557Abramovitch A, Dar R, Mittelman A, Wilhelm S.Comorbidity Between Attention Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder Across the Lifespan: A Systematic and Critical Review. Harv Rev Psychiatry. 2015;23(4):245-62. doi:10.1097/HRP.0000000000000050

17 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.International OCD Foundation.Who gets OCD?Brem S, Grünblatt E, Drechsler R, Riederer P, Walitza S.The neurobiological link between OCD and ADHD.Atten Defic Hyperact Disord. 2014;6(3):175-202. doi:10.1007/s12402-014-0146-xPark JM, Samuels JF, Grados MA, et al.ADHD and executive functioning deficits in OCD youths who hoard.Journal of Psychiatric Research. 2016;82:141-148. doi:10.1016/j.jpsychires.2016.07.024Cabarkapa S, King JA, Dowling N, Ng CH.Co-morbid obsessive-compulsive disorder and attention deficit hyperactivity disorder: Neurobiological commonalities and treatment implications.Front Psychiatry. 2019;10:557. doi:10.3389/fpsyt.2019.00557Norman LJ, Carlisi C, Lukito S, et al.Structural and functional brain abnormalities in attention-deficit/hyperactivity disorder and obsessive-compulsive disorder: A comparative meta-analysis.JAMA Psychiatry.2016;73(8):815–825. doi:10.1001/jamapsychiatry.2016.0700Kedem S, Yust-Katz S, Carter D, et al.Attention deficit hyperactivity disorder and gastrointestinal morbidity in a large cohort of young adults.World J Gastroenterol. 2020;26(42):6626-6637. doi: 10.3748/wjg.v26.i42.6626van Lieshout M, Luman M, Twisk JW, et al.A 6-year follow-up of a large European cohort of children with attention-deficit/hyperactivity disorder-combined subtype: outcomes in late adolescence and young adulthood.Eur Child Adolesc Psychiatry. 2016;25(9):1007-1017. doi:10.1007/s00787-016-0820-ySinopoli VM, Burton CL, Kronenberg S, Arnold PD.A review of the role of serotonin system genes in obsessive-compulsive disorder.Neurosci Biobehav Rev. 2017;80:372‐381. doi:10.1016/j.neubiorev.2017.05.029Salvi V, Migliarese G, Venturi V, et al.ADHD in adults: clinical subtypes and associated characteristics. Riv Psichiatr. 2019;54(2):84-89. doi:10.1708/3142.31249Abramovitch A.Misdiagnosis of ADHD in individuals diagnosed with obsessive-compulsive disorder: Guidelines for practitioners.Curr Treat Options Psych. 2016;3(3):225-234. doi:10.1007/s40501-016-0084-7Mahone EM, Denckla MB.Attention-Deficit/Hyperactivity Disorder: A Historical Neuropsychological Perspective. J Int Neuropsychol Soc. 2017;23(9-10):916-929. doi:10.1017/S1355617717000807Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).Coexisting conditions.Mersin Kilic S, Dondu A, Memis CO, Ozdemiroglu F, Sevincok L.The clinical characteristics of adhd and obsessive-compulsive disorder comorbidity.J Atten Disord. 2020;24(12):1757-1763. doi:10.1177/1087054716669226Guzick AG, McNamara JPH, Reid AM, et al.The link between ADHD-like inattention and obsessions and compulsions during treatment of youth with OCD.J Obsessive Compuls Relat Disord. 2017;12:1-8. doi: 10.1016/j.jocrd.2016.11.004Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ.Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017;17(1):302. doi:10.1186/s12888-017-1463-3Cabarkapa S, King JA, Dowling N, Ng CH.Co-morbid obsessive-compulsive disorder and attention deficit hyperactivity disorder: Neurobiological commonalities and treatment implications.Front Psychiatry. 2019;10:557. doi:10.3389/fpsyt.2019.00557Abramovitch A, Dar R, Mittelman A, Wilhelm S.Comorbidity Between Attention Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder Across the Lifespan: A Systematic and Critical Review. Harv Rev Psychiatry. 2015;23(4):245-62. doi:10.1097/HRP.0000000000000050

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

International OCD Foundation.Who gets OCD?Brem S, Grünblatt E, Drechsler R, Riederer P, Walitza S.The neurobiological link between OCD and ADHD.Atten Defic Hyperact Disord. 2014;6(3):175-202. doi:10.1007/s12402-014-0146-xPark JM, Samuels JF, Grados MA, et al.ADHD and executive functioning deficits in OCD youths who hoard.Journal of Psychiatric Research. 2016;82:141-148. doi:10.1016/j.jpsychires.2016.07.024Cabarkapa S, King JA, Dowling N, Ng CH.Co-morbid obsessive-compulsive disorder and attention deficit hyperactivity disorder: Neurobiological commonalities and treatment implications.Front Psychiatry. 2019;10:557. doi:10.3389/fpsyt.2019.00557Norman LJ, Carlisi C, Lukito S, et al.Structural and functional brain abnormalities in attention-deficit/hyperactivity disorder and obsessive-compulsive disorder: A comparative meta-analysis.JAMA Psychiatry.2016;73(8):815–825. doi:10.1001/jamapsychiatry.2016.0700Kedem S, Yust-Katz S, Carter D, et al.Attention deficit hyperactivity disorder and gastrointestinal morbidity in a large cohort of young adults.World J Gastroenterol. 2020;26(42):6626-6637. doi: 10.3748/wjg.v26.i42.6626van Lieshout M, Luman M, Twisk JW, et al.A 6-year follow-up of a large European cohort of children with attention-deficit/hyperactivity disorder-combined subtype: outcomes in late adolescence and young adulthood.Eur Child Adolesc Psychiatry. 2016;25(9):1007-1017. doi:10.1007/s00787-016-0820-ySinopoli VM, Burton CL, Kronenberg S, Arnold PD.A review of the role of serotonin system genes in obsessive-compulsive disorder.Neurosci Biobehav Rev. 2017;80:372‐381. doi:10.1016/j.neubiorev.2017.05.029Salvi V, Migliarese G, Venturi V, et al.ADHD in adults: clinical subtypes and associated characteristics. Riv Psichiatr. 2019;54(2):84-89. doi:10.1708/3142.31249Abramovitch A.Misdiagnosis of ADHD in individuals diagnosed with obsessive-compulsive disorder: Guidelines for practitioners.Curr Treat Options Psych. 2016;3(3):225-234. doi:10.1007/s40501-016-0084-7Mahone EM, Denckla MB.Attention-Deficit/Hyperactivity Disorder: A Historical Neuropsychological Perspective. J Int Neuropsychol Soc. 2017;23(9-10):916-929. doi:10.1017/S1355617717000807Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).Coexisting conditions.Mersin Kilic S, Dondu A, Memis CO, Ozdemiroglu F, Sevincok L.The clinical characteristics of adhd and obsessive-compulsive disorder comorbidity.J Atten Disord. 2020;24(12):1757-1763. doi:10.1177/1087054716669226Guzick AG, McNamara JPH, Reid AM, et al.The link between ADHD-like inattention and obsessions and compulsions during treatment of youth with OCD.J Obsessive Compuls Relat Disord. 2017;12:1-8. doi: 10.1016/j.jocrd.2016.11.004Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ.Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017;17(1):302. doi:10.1186/s12888-017-1463-3Cabarkapa S, King JA, Dowling N, Ng CH.Co-morbid obsessive-compulsive disorder and attention deficit hyperactivity disorder: Neurobiological commonalities and treatment implications.Front Psychiatry. 2019;10:557. doi:10.3389/fpsyt.2019.00557Abramovitch A, Dar R, Mittelman A, Wilhelm S.Comorbidity Between Attention Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder Across the Lifespan: A Systematic and Critical Review. Harv Rev Psychiatry. 2015;23(4):245-62. doi:10.1097/HRP.0000000000000050

International OCD Foundation.Who gets OCD?

Brem S, Grünblatt E, Drechsler R, Riederer P, Walitza S.The neurobiological link between OCD and ADHD.Atten Defic Hyperact Disord. 2014;6(3):175-202. doi:10.1007/s12402-014-0146-x

Park JM, Samuels JF, Grados MA, et al.ADHD and executive functioning deficits in OCD youths who hoard.Journal of Psychiatric Research. 2016;82:141-148. doi:10.1016/j.jpsychires.2016.07.024

Cabarkapa S, King JA, Dowling N, Ng CH.Co-morbid obsessive-compulsive disorder and attention deficit hyperactivity disorder: Neurobiological commonalities and treatment implications.Front Psychiatry. 2019;10:557. doi:10.3389/fpsyt.2019.00557

Norman LJ, Carlisi C, Lukito S, et al.Structural and functional brain abnormalities in attention-deficit/hyperactivity disorder and obsessive-compulsive disorder: A comparative meta-analysis.JAMA Psychiatry.2016;73(8):815–825. doi:10.1001/jamapsychiatry.2016.0700

Kedem S, Yust-Katz S, Carter D, et al.Attention deficit hyperactivity disorder and gastrointestinal morbidity in a large cohort of young adults.World J Gastroenterol. 2020;26(42):6626-6637. doi: 10.3748/wjg.v26.i42.6626

van Lieshout M, Luman M, Twisk JW, et al.A 6-year follow-up of a large European cohort of children with attention-deficit/hyperactivity disorder-combined subtype: outcomes in late adolescence and young adulthood.Eur Child Adolesc Psychiatry. 2016;25(9):1007-1017. doi:10.1007/s00787-016-0820-y

Sinopoli VM, Burton CL, Kronenberg S, Arnold PD.A review of the role of serotonin system genes in obsessive-compulsive disorder.Neurosci Biobehav Rev. 2017;80:372‐381. doi:10.1016/j.neubiorev.2017.05.029

Salvi V, Migliarese G, Venturi V, et al.ADHD in adults: clinical subtypes and associated characteristics. Riv Psichiatr. 2019;54(2):84-89. doi:10.1708/3142.31249

Abramovitch A.Misdiagnosis of ADHD in individuals diagnosed with obsessive-compulsive disorder: Guidelines for practitioners.Curr Treat Options Psych. 2016;3(3):225-234. doi:10.1007/s40501-016-0084-7

Mahone EM, Denckla MB.Attention-Deficit/Hyperactivity Disorder: A Historical Neuropsychological Perspective. J Int Neuropsychol Soc. 2017;23(9-10):916-929. doi:10.1017/S1355617717000807

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).Coexisting conditions.

Mersin Kilic S, Dondu A, Memis CO, Ozdemiroglu F, Sevincok L.The clinical characteristics of adhd and obsessive-compulsive disorder comorbidity.J Atten Disord. 2020;24(12):1757-1763. doi:10.1177/1087054716669226

Guzick AG, McNamara JPH, Reid AM, et al.The link between ADHD-like inattention and obsessions and compulsions during treatment of youth with OCD.J Obsessive Compuls Relat Disord. 2017;12:1-8. doi: 10.1016/j.jocrd.2016.11.004

Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ.Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017;17(1):302. doi:10.1186/s12888-017-1463-3

Abramovitch A, Dar R, Mittelman A, Wilhelm S.Comorbidity Between Attention Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder Across the Lifespan: A Systematic and Critical Review. Harv Rev Psychiatry. 2015;23(4):245-62. doi:10.1097/HRP.0000000000000050

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