The relationship between adult attention deficit hyperactivity disorder and generalized anxiety disorder

The aim of this study is to determine the rates of co-diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and Generalized Anxiety Disorder (GAD) in adult patients and to examine the symptom profiles in patients with both diagnoses. The study sample consisted of a total of 89 participants, including 59 patients who had previously been diagnosed with ADHD and/or GAD at two private clinics in Ankara between September 2023 and June 2024, and 30 healthy controls with no prior psychiatric diagnosis/treatment and no psychiatric complaints. Structured diagnostic interviews using the SCID-5-CV (ADHD Module) and MINI (GAD Module) were conducted with all participants. Then, Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS-v1.1) and Wender-Utah Rating Scale (WURS) were administered to measure ADHD symptoms and Generalized Anxiety Disorder-7 (GAD-7) and Beck Anxiety Inventory (BAI) were administered to assess GAD symptoms. Data were collected both face-to-face and online. Of the 59 individuals included in the study with a prediagnosis of ADHD, 53 (89.8%) met the diagnostic criteria and 39 (66.1%) had ADHD- Combined subtyped, 11 (18.6%) had ADHD- Predominantly Inattentive subtyped, and 3 (5.1%) had ADHD-Predominantly "Hyperactive/Impulsive" subtyped. When 59 individuals were evaluated for GAD with the MINI (GAD Module), 57 (96.6%) met the diagnostic criteria for GAD, 38 (64.4%) met the criteria for GAD + ADHD-Compound manifestation, 10 (16.9%) for GAD + ADHD-PI, 3 (5.1%) for GAD + ADHD-HI, 6 (10.2%) for GAD only, and 2 (3.4%) for ADHD only. In the research group, 11 ADHD-Predominantly Inattentive subtyped (ADHD-PI) patients were analyzed in one group (n=11); 39 ADHD-Combined subtyped patients and 3 ADHD-Predominantly "Hyperactive/Impulsive" subtyped (ADHD-HI) patients (n=42) were analyzed in a separate group (ADHD-Other); and 6 patients diagnosed with GAD only were analyzed as one group. When the findings were compared between subgroups, the rate of co-occurrence of these two diagnoses was 86.4% and a high level of comorbidity between ADHD and GAD was found in the study. According to the scores obtained from the self-report scales, significant differences were found between the ADHD-PI, ADHD-Other, and GAD groups. Participants in the ADHD-Other group, in particular, scored highest on all scales in terms of both attention and impulsivity symptoms and anxiety levels. Correlation analyses revealed that there were significant positive correlations between the total and subscale scores of the ASRS and the anxiety scales (GAD-7 and BAI). It is understood that as the ADHD symptom spectrum becomes broader, anxiety symptoms also increase. Similarly, significant positive correlations were found between the BAI total score and WURS total score, WURS-Behavioral Problems/Impulsivity subscale and WURS-Irritability subscale. This indicates that ADHD symptoms that persist since childhood may increase the level of anxiety in adulthood. These findings suggest that increasing severity of ADHD symptoms may be associated with a parallel increase in anxiety symptoms. These findings suggest that an increase in the severity of ADHD symptoms may be associated with a parallel increase in anxiety symptoms. In the light of these findings, it is concluded that ADHD and GAD are frequently seen together in adulthood, that this association significantly affects symptom profiles and that the possible presence of the other diagnosis should be investigated in patients with one of these diagnoses in clinical evaluations.