Liping Dong,1,2 Ting Sun,2 Ping Tong,2 Xiaoyan Ke1 

1Affifiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, People’s Republic of China; 2Department of Clinical Psychology, Northern Jiangsu People’s Hospital, Yangzhou, 225001, People’s Republic of China

Correspondence: Ping Tong, Department of Clinical Psychology, Northern Jiangsu People’s Hospital, No. 98, Nantong West Road, Yangzhou, 225001, People’s Republic of China, Email yztpfrh@sina.com Xiaoyan Ke, Affiliated Nanjing Brain Hospital, Nanjing Medical University, 264 Guangzhou Road, Nanjing, Jiangsu Province, 210029, People’s Republic of China, Email kexiaoyan@njmu.edu.cn

Background: Comorbidity between attention-deficit/hyperactivity disorder (ADHD) and depression in adults is frequently observed and is associated with more complex clinical presentations and poorer prognoses. Greater emphasis is therefore warranted on identifying the distinguishing clinical characteristics of this comorbid condition.
Objective: To examine the clinical differences between adults diagnosed with depression with and without comorbid ADHD.
Methods: A cross-sectional comparative analysis was conducted involving patients with MDD, with and without comorbid ADHD. Sociodemographic and clinical variables were collected. Multivariate logistic regression analysis was performed to identify factors independently associated with ADHD comorbidity.
Results: A total of 197 patients were included in the final analysis. Significant differences in both sociodemographic and clinical variables were observed between the two groups. Multivariate logistic regression revealed that earlier age of onset (OR = 1.86, 95% CI: 1.25– 7.31), lower educational attainment (OR = 0.43, 95% CI: 0.22– 0.86), higher PHQ-9 scores (OR = 2.31, 95% CI: 1.58– 6.52), poor emotional impulsivity control (OR = 4.55, 95% CI: 2.58– 8.01), and maladaptive emotion regulation strategies (OR = 3.24, 95% CI: 2.07– 7.45) were significantly associated with the presence of ADHD in patients with depression.
Conclusion: Adults with comorbid depression and ADHD demonstrate distinct clinical features compared to those with depression alone. Key predictive factors include earlier onset of depression, lower levels of education, more severe depressive symptoms, greater difficulties in emotional impulsivity control, and the use of maladaptive emotion regulation strategies. These findings underscore the need for comprehensive assessment of emotion regulation in depressive patients, as such difficulties may signal the presence of comorbid ADHD. Interventions targeting emotional regulation may enhance diagnostic accuracy and improve treatment outcomes in this population.

Keywords: depression, ADHD, comorbidity, emotion dysregulation