Jul 2026· Revista de Estudos Interdisciplinares· Vol 25, pp. e3445· 0 citations
TL;DR
A high frequency of positive screening results for symptoms suggestive of ADHD and ASD, significant overlap between these conditions, and a low proportion of self-reported formal diagnoses are revealed.
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are neurodevelopmental conditions that can persist into adulthood and are associated with functional impairments, psychological distress, and challenges in diagnosis. This study aimed to investigate the screening for symptoms suggestive of ADHD and ASD, as well as the history of formal diagnoses, among Brazilian adults. It was a descriptive, cross-sectional, and correlational study using a quantitative approach, conducted via online data collection and a virtual snowball sampling method. The instruments used included a sociodemographic and clinical questionnaire, the ASRS-18, and the AQ-10. The results revealed a high frequency of positive screening results for symptoms suggestive of ADHD and ASD, significant overlap between these conditions, and a low proportion of self-reported formal diagnoses. The findings underscore the importance of screening and qualified clinical assessment of neurodevelopmental conditions in adulthood, as well as the need to expand professional training and access to specialized mental health services for diagnosis and follow-up.
Background: ADHD is characterized by inattention, hyperactivity, impulsivity, and affects 8.4% of children and 2.5% of adults. Lower diagnosis rates in females suggest a different clinical presentation, contributing to delayed diagnoses and negative outcomes across multiple domains of functioning.
Aim: This study examines underdiagnosed ADHD in women, assessing its impact on functioning in adulthood, including mental health, quality of life, and long-term impairments.
Material and methods: A literature review using PubMed/MEDLINE (2010–2025) included clinical, longitudinal cohort, and epidemiological research addressing sex differences in ADHD diagnosis, symptom presentation, and long-term functional outcomes, with a focus on the female population.
Results: Women with ADHD are significantly underdiagnosed in childhood, often receiving diagnosis only in adulthood after years of treatment for comorbidities such as anxiety, depression, or personality disorders. Internalized symptoms and emotional dysregulation frequently mask core ADHD features. Late diagnosis is associated with impaired educational and occupational achievement, relationship instability, low self-esteem, substance misuse, reduced quality of life, and increased risk of self-harm and suicide attempts. ADHD in women also increases risk of psychiatric and obstetric complications, including teenage pregnancy, smoking during pregnancy, substance misuse, and postpartum depression and anxiety.
Conclusions: Underdiagnosis of ADHD in women remains a significant clinical and public health issue. Greater awareness of sex-specific symptom presentation and improved diagnostic strategies are essential to prevent long-term psychosocial consequences and improve quality of life in affected women.
N. Samp, P. Trzepizur, Kamila Zera et al.· Quality in Sport· 0 citations
There is an urgent need for prospective longitudinal studies to adequately map the aging trajectories of this population of older adults with ASD, which constitute a vulnerable population.
J. P. S. Gontijo, Marcelo H S S Martins, L. M. Alves· Trends in Psychiatry and Psy...· 0 citations
Highlights What are the main findings? Children with ADHD showed the highest overall emotional–behavioral burden, whereas ASD and SLD were characterized by greater internalizing difficulties and DMD by a distinct emotional–behavioral profile. Using the same standardized CBCL/6–18 assessment enabled direct comparison of emotional and behavioral functioning across neurodevelopmental and neuromuscular conditions. What is the implication of the main finding? A transdiagnostic assessment framework may facilitate the identification of both shared and disorder-specific emotional–behavioral patterns across heterogeneous pediatric populations. Integrating standardized behavioral screening with individualized clinical assessment may support more targeted psychosocial care and multidisciplinary decision-making. Abstract Background: Neurodevelopmental disorders, including Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and Specific Learning Disorder (SLD), as well as neuromuscular conditions such as Duchenne Muscular Dystrophy (DMD), are frequently associated with emotional and behavioral difficulties that may affect children’s functioning and family well-being. However, direct comparisons across these heterogeneous clinical populations remain limited. This study aimed to compare emotional and behavioral profiles across children and adolescents with ASD, ADHD, SLD, and DMD using the Child Behavior Checklist (CBCL/6–18). Methods: This cross-sectional comparative study included 197 children and adolescents (ASD: 47; SLD: 50; ADHD: 50; DMD: 50) assessed at the Clinical Psychology Unit of the Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Rome, Italy) between 2017 and 2024. Emotional and behavioral functioning was evaluated using the parent-report CBCL/6–18. Group differences were examined using one-way ANOVA or Welch’s ANOVA, as appropriate, followed by Tukey’s HSD or Games–Howell post hoc comparisons. Results: Significant group differences emerged for Internalizing Problems, Externalizing Problems, and Total Problems (all p < 0.001). ADHD showed the highest overall emotional and behavioral burden, with 76% of participants scoring in the clinical range for both Internalizing and Total Problems and 60% for Externalizing Problems. Elevated internalizing difficulties characterized ASD and SLD, whereas children with DMD showed generally lower CBCL scores, although 26% fell within the clinical range for Internalizing Problems. Effect sizes were moderate to large (η2 = 0.168–0.273), supporting the presence of both shared and disorder-specific emotional and behavioral patterns across heterogeneous developmental conditions. Conclusions: The findings highlight the heterogeneity of emotional–behavioral profiles across neurodevelopmental and neuromuscular conditions. The use of a common standardized assessment framework enabled the identification of both shared and disorder-specific patterns, supporting the potential value of a transdiagnostic approach to individualized assessment. Future longitudinal and multi-informant studies are warranted to clarify developmental trajectories and improve the identification of clinically meaningful emotional and behavioral needs across heterogeneous pediatric populations.
D. P. Chieffo, Federica Moriconi, Valentina Delle Donne et al.· Children· 0 citations
BACKGROUND
Catatonia, a psychomotor syndrome increasingly recognized in individuals with autism spectrum disorder (ASD), remains frequently underdiagnosed due to symptom overlap, particularly in adolescent populations where data remain limited. This study aimed to determine the prevalence, clinical correlates and predictive factors of catatonia in adolescents with ASD, focusing on sociodemographic, behavioural and affective characteristics.
METHODS
A total of 107 adolescents aged 12-20 years with ASD were evaluated at a tertiary child and adolescent psychiatry outpatient clinic. The diagnosis of catatonia was established using DSM-5 criteria and the Bush-Francis Catatonia Rating Scale (BFCRS). ASD severity, repetitive behaviours and internalizing symptoms were assessed using the Global Assessment Scale, the Autism Behaviour Checklist (ABC), the Repetitive Behaviour Scale-Revised (RBS-R) and the Revised Child Anxiety and Depression Scale-Parent version (RCADS-P). Group comparisons, correlation analyses and binary logistic regression were performed.
RESULTS
Catatonia was identified in 21.5% of participants. The most frequent symptoms were stereotypy (73.8%), impulsivity (37.4%), echolalia (36.4%), verbigeration (30.8%) and agitation/excitement (30.8%). Female sex, greater ASD severity, depressive symptoms and separation anxiety were significantly associated with catatonia. The catatonia group demonstrated higher scores on the ABC-Relationship Building, RBS-R-Stereotyped Behaviour and RCADS-P-Depression subscales. Logistic regression revealed that female gender and clinically significant separation anxiety symptoms were independent predictors of catatonia (Nagelkerke R2 = 0.26, p < 0.001).
CONCLUSIONS
These findings highlight the importance of targeted screening for catatonia in ASD populations, particularly in females and individuals with co-occurring separation anxiety symptoms. Early recognition and intervention may mitigate functional deterioration and improve clinical outcomes.
Rahime Duygu Temelturk, Esra Yurumez, B. Kaymak et al.· Journal of Intellectual Disa...· 0 citations
Attention-deficit/hyperactivity disorder (ADHD) is a predominantly childhood-onset neurodevelopmental disorder. However, ADHD is not limited to childhood. The disorder has a highly heterogeneous developmental trajectory from childhood into adulthood, ranging from full remission to persistence of ADHD with adverse outcomes. The research in this thesis largely used data from the 18-year follow-up study of the IMAGE/NeuroIMAGE cohort. This follow-up successfully included 421 participants, among which adults (Mage = 28.84) with childhood ADHD (n = 154), their siblings (n = 138), and controls (n = 129). Outcomes collected at follow-up included 51 measures across 7 domains of functioning, including psychiatric status, behavioral and emotional problems, academic and professional functioning, adaptive functioning, neurocognitive functioning, physical health,
and healthcare service use.
Compared to their siblings and controls, adults with childhood ADHD showed worse long-term outcomes on more than 60% of the outcomes across the 7 domains of functioning, while their other outcomes were similar. Most group differences lay in the domains of behavioral and emotional problems, adaptive functioning, and neurocognitive functions. These negative outcomes seemed to be largely independent of a current ADHD diagnosis, as both the group with persistent ADHD and the group with remitted ADHD differed from the controls on the majority of outcomes. Siblings did not show an increased risk of negative outcomes.
Among adults with a history of childhood ADHD, only 26% used ADHD medication in adulthood. Also, they were 3 to 7 times more likely to use neurological medications (analgesics and NSAIDs). Differences in medication use largely disappeared after adjusting for a current ADHD diagnosis or depression. Overall, differences between men and women were comparable to those observed in the general population; there was no evidence of a "double burden" of sex regarding ADHD.
Our meta-analyses showed that a history of stimulant use was associated with an increased risk of ADHD persistence. Additionally, ADHD persistence was associated with an increased risk of depression and addiction. Our own machine-learning-based prediction models did not predict long-term ADHD outcomes any better than conventional logistic regression. Despite suboptimal performance, several potentially relevant predictors were identified: anxiety symptoms, autistic traits, and childhood motor coordination problems.
The key takeaway is that the developmental trajectory into adulthood is heterogeneous and difficult to predict. While one group will achieve average adult functioning, adults with a childhood ADHD diagnosis have an elevated risk of difficulties, particularly psychiatric disorders and behavioral or emotional problems. In our sample, childhood stimulant use was not associated with long-term functional outcomes (assessed more than 10 years later).
Cognitive Disengagement Syndrome (CDS) is characterized by symptoms such as daydreaming, slowed behavior, and mental confusion, but remains understudied outside of ADHD populations. CDS has recently emerged as a potential transdiagnostic construct, yet most investigations have been limited to ADHD samples. To further clarify the clinical profile of CDS, research is needed in pediatric mood disorder populations and comorbid presentations. This study examined predictors of caregiver-reported CDS symptoms in a racially and socioeconomically diverse sample of treatment-seeking outpatient youth (N = 697), with attention to psychiatric diagnoses (ADHD and mood disorders), youth demographics, caregiver education, and number of other psychiatric diagnoses. A 5-item CBCL-based CDS index demonstrated acceptable psychometric performance and was used to capture youth CDS levels. Hierarchical regression revealed that mood disorder diagnosis was the strongest and most unique predictor of elevated CDS symptoms, followed by ADHD diagnosis, with the comorbid group (ADHD+Mood) showing the highest CDS levels. Clinical and structural factors, including mood and ADHD diagnoses, number of other psychiatric diagnoses, Black racial identity, lower caregiver education, and older age, each independently predicted CDS severity. These findings support CDS as a clinically meaningful construct extending beyond ADHD and underscore the importance of contextually informed, transdiagnostic assessment. Implications are discussed through a developmental psychopathology framework, emphasizing equifinality.
E. Choplin, Casey D. Calhoun, J. Youngstrom et al.· Child Neuropsychology: A Jou...· 0 citations