Correlations between attention deficit/hyperactivity disorder, obsessive-compulsive disorder and tics in children and adolescents: case report

Abstract

The relationship between the attention defi cit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) and tics is primarilydiscussed through genetic, neurobiological, neurocognitive and neurochemical substrates of reduced impulse control. Thecomorbidity of these disorders in children and adolescents is not a rarity. In our 14-year-old patient, ADHD and simple motor ticswere diagnosed at pre-school age and OCD at the age of 10. We diagnosed these disorders by DSM-IV criteria and semi-structuredinterviews based on it. In a multimodal treatment we used techniques from cognitive behavioural psychotherapy, psychoeducationand parental support, sensory integration therapy with a assistance dog, neurofeedback, medication therapy (methylphenidate,fl uvoxamine), group therapy aimed at enhancing social skills and expressing emotions, individualized approach to learning inschool with a personal assistant. We discuss the complexity of treatment of clinical presentation complicated by comorbidity andemotional distress, and some known and possible links between these disorders. Treatment of ADHD demands multimodal approachand cooperation of diff erent professionals. Among other things, timely recognition of associated symptoms and other psychiatricdisorders and their linkage is very important to prevent intensifi cation of symptoms and signs of the disorder and to determinetherapeutic guidelines. Further investigation is needed.Key words: ATTENTION DEFICIT/HYPERACTIVITY DISORDER; COMORBIDITY; TREATMENT; CHILDREN; ADOLESCENTS