ADHD Presentations and Severity in Adults: Psychometric Profiles, Psychiatric Comorbidities, and Emotional Dysregulation in Relation to Psychiatric Hospitalization

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) in adults is heterogeneous in symptom presentation, severity, and comorbid psychopathology, yet systematic data from Italian clinical populations remain limited.

Methods

In this retrospective, cross-sectional study, we analyzed routine clinical data from 219 adults with a DSM-5 diagnosis of ADHD at a specialist mental health service in Milan. We compared psychometric profiles and psychiatric comorbidities across ADHD presentations (Combined vs. Inattentive), examined the associations of clinician-rated ADHD severity with dimensional and categorical outcomes, and explored, in an exploratory cross-sectional indirect-effect analysis, whether emotional dysregulation statistically accounted for the association between ADHD severity and psychiatric hospitalization. Multiplicity was addressed with Holm and false-discovery-rate procedures within predefined families of outcomes. Measures included the Zung Depression Scale, STAI, Difficulties in Emotion Regulation Scale (DERS), Internet Addiction Test, Adult ADHD Quality of Life Scale, Barratt Impulsiveness Scale, and the SCID-5-PD. Analyses comprised MANCOVA, multiple linear and binary logistic regression, and an exploratory indirect-effect analysis (PROCESS Model 4).