Attention-deficit hyperactivity disorder (ADHD) has been associated with compulsive sexual behaviours, including problematic pornography use. However, symptom-level mechanisms underlying this relationship remain poorly characterised, particularly across diverse demographic groups.

To identify key ADHD symptoms that bridge to compulsive sexual behaviour phenotypes (compulsive sexual behaviours and problematic pornography use) and examine whether symptom-level associations differ across sex, gender identity and age groups.

This cross-sectional study analysed data from the International Sex Survey (2021–2022). Participants completed the Adult ADHD Self-Report Screening Scale, Compulsive Sexual Behaviour Disorder Scale and Problematic Pornography Consumption Scale. Gaussian graphical models and Bayesian networks were used to assess symptom-level relationships. Centrality and bridging indices were computed. Network comparison tests were also used to assess for any differences in network invariance and global strength across multiple demographic subgroups. Directed acyclic graphs were constructed to consider potential causal pathways.

Among 82 243 participants (48 987 men (59.6%), 33 245 women (40.4%), mean age 33.1 years), ADHD symptoms of inattention and hyperactivity–impulsivity emerged as central, bridging and directionally plausible nodes. Network comparisons revealed demographic differences in overall network strength, with men and cisgender individuals exhibiting higher frequencies of association. Nonetheless, items relating to both inattention and hyperactivity–impulsivity consistently emerged as central across all population subgroups.

The finding suggesting that ADHD symptoms of inattention and hyperactivity–impulsivity are key drivers of compulsive sexual behaviours across global populations and multiple sociodemographic characteristics underscores the relevance of transdiagnostic mechanisms and suggests use of targeted interventions addressing executive dysfunction and reward dysregulation in ADHD.

Diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and autism have broadened and are common at estimated adult prevalences of 3%. This paper explores the incidence of autism and overlap of features in ADHD young adults transitioning from Child and Adolescents Mental Health Services (CAMHS) into a specialist adult ADHD service, and the utility of the Ritvo Autism Asperger Diagnostic Scale 14 (RAADS-14) assisting assessment and support planning.

This comparative cohort study included all young adult ADHD patients referred from CAMHS. A comprehensive assessment and diagnostic formulation, including RAADS-14 was completed. Those without a current autism diagnosis but clinical assessment suggested autism, underwent further assessment. Percentage of autistic and ADHD young adults was calculated. RAADS-14 total and subscale scores were compared between groups. Gender differences were assessed.

Co-occurrence of autism in a group of young adults diagnosed with ADHD was high (53%). High levels of autism features were evident in the ADHD only group. Significant differences in the RAADS-14 sub-scores (social anxiety, mentalizing and sensory sensitivities) were found between the autistic ADHD and non autistic ADHD groups. Autistic females scored higher on all domains of the RAADS-14 compared to males. Sensory sensitivities were significantly higher in females in both groups.

The level of co-occurrence of autism, and overlap of features, suggests employment of neurodevelopmental rather than single condition approaches to avoid mis-diagnosis/missed diagnoses. Sensory sensitivities are suggestive of neurodevelopmental differences particularly in females regardless of diagnostic category. The RAADS-14 may be helpful as part of screening and support planning.

Attention-deficit and hyperactivity disorder (ADHD) is a prevalent neuropsychiatric disorder. Recently, psychedelics have become of interest regarding developing treatment options for ADHD. The aim of this systematic review is to find all studies from the APA PsychInfo and MEDLINE databases, where psychedelics have been used for ADHD and assess whether further clinical studies are warranted.

APA PsychInfo and MEDLINE were searched on the 20th of August 2025 for studies discussing ADHD and lysergic acid diethylamide (LSD) or psilocybin or dimethyltryptamine (DMT) or mescaline or phencyclidine or 3,4-methylenedioxymethamphetamine (MDMA) or ketamine. Primary research articles in English where the effects of the psychedelics mentioned on ADHD in humans were included.

N = 1023 results were identified. Six studies were included – one randomised controlled trial (RCT) finding no statistically important difference compared to placebo, three cross-sectional studies where respondents reported positive effect of psychedelics and one where the statistically important improvement was measured by the Child Bipolar Questionnaire. In addition, one case study, where both, depressive symptoms and functioning improved with ketamine.

There is not sufficient evidence to give recommendations on psychedelic use for ADHD. In addition, it is not known whether patients, whose depressive symptoms have responded positively to ketamine, have also had ADHD. Also, no research was found on how psychedelics affect patient subgroups with different etiopathology causing their symptoms. Although only six studies filled the inclusion criteria, they bring out valuable implications for further research.

Children and adolescents with attention–deficit hyperactivity disorder (ADHD) have a higher likelihood of contact with child welfare services (CWS). Evidence on whether pharmacological treatment of ADHD reduces such contact is limited.

To estimate the causal effect of pharmacological treatment of ADHD on CWS contact.

In this quasi-experimental study, we used nationwide registry data covering all individuals aged 5–14 years and diagnosed with ADHD during 2009–2011 in Norway. We used linear probability models and instrument variable analyses to estimate the associations and causal effects of pharmacological treatment on CWS contact up to 4 years after diagnosis. As instrument variable analysis uses natural variation in treatment decisions between clinics as pseudo-randomisation, estimates inform effects for children and adolescents at the margin of treatment, i.e. patients whose treatment is more influenced by variation in treatment practice, e.g. due to less severe or atypical symptom presentation.

A total of 5930 children and adolescents aged 5–14 years were diagnosed with ADHD between 2009 and 2011 (mean (s.d.) age 10.1 (2.4) years; 4380 males (73.9%)). Instrument variable analyses showed a reducing effect of pharmacological treatment on the use of supportive interventions by 11.9 percentage points (95% CI: −20.12, −3.80) and out-of-home-placement by 3.30 percentage points (95% CI: −6.44, −0.15) at 2-year follow-up. This corresponds to the numbers needed to treat estimates of 8 and 30, respectively.

Pharmacological treatment of ADHD reduces CWS contact among children and adolescents at the margin of treatment, lowering the probability of receiving supportive interventions and out-of-home placements. Findings suggest that medication reduces behavioural symptoms, which may improve the family coping mechanism and reduces the need for CWS involvement.

ISRCTN11891971.

Children with attention-deficit/hyperactivity disorder (ADHD) frequently exhibit impairing emotional dysregulation along with inattention and hyperactivity. We aim to parse the heterogeneity of behavioral and emotional dysregulation in ADHD using latent brain factors based on cortical thickness (CT), and examine associated differences in intrinsic functional connectivity (iFC).

Data were collected from 123 children (39 ADHD, 47 ADHD with impairing emotional outbursts [ADHD + IEO], 37 neurotypical controls [NT], 5–9.9 years old). First, exploratory factor analysis revealed latent behavioral factors. Using Latent Dirichlet allocation, we decomposed heterogeneous CT patterns into parsimonious latent brain factors. We further investigated the functional relevance of brain regions showing structural differences in the ADHD + IEO group and examined associations between brain and behavioral latent factors.

Among the four behavioral factors identified (Externalizing, Emotion Dysregulation, Internalizing, and Surgency/Impulsivity), the dominant factor – Externalizing behavior – significantly differentiated the ADHD + IEO from the ADHD and NT groups. A conjunction analysis of the three brain factors revealed significantly thicker CT in the dorsolateral prefrontal cortex for ADHD + IEO compared to NT. Using this region as a seed, we found reduced functional connectivity primarily in the default mode network, which differentiated ADHD + IEO and ADHD groups. Structural brain and iFC measures showed significant associations with the Externalizing behavior factor.

Parsing the neurobiology underlying the heterogeneous presentation of ADHD requires integrating multiple modalities and analytical methods. This study demonstrates that combining behavioral, structural, and functional data reveals unique neural features associated with behavioral and emotional dysregulation.

Neurodivergence encompasses neurodevelopmental conditions including autism, attention-deficit hyperactivity disorder (ADHD) and Tourette syndrome. Particular physical traits, notably those linked to joint hypermobility, have an established association with both neurodivergence and bipolar affective disorder.

This case-control study tested, first, whether the presence of joint hypermobility predicted bipolar affective disorder and, secondly, whether neurodivergent characteristics were important in understanding this relationship.

Data were collected from 52 participants with self-reported clinical diagnoses of bipolar affective disorder and from a comparison group of 54 participants without diagnosis of bipolar affective disorder. All participants were assessed on screening instruments for autism (Ritvo Autism Asperger Diagnostic Scale; RAADS-R), ADHD (Wender Utah Rating Scale; WURS) and joint hypermobility. Group differences were explored, and odds ratios calculated for the presence of bipolar and neurodivergence given the presence of hypermobility. A mediation analysis was performed to determine the contribution of neurodivergent characteristics to the relationship between joint hypermobility and bipolar affective disorder.

The presence of joint hypermobility significantly predicted the presence of bipolar disorder (odds ratio 5.1; 95% CI = 2.1, 12.4). In the bipolar affective disorder group, the prevalence of likely autism and ADHD was greater (84.6 and 65.4% respectively) than in the comparison group (22.2 and 3.7% respectively). The odds ratio for a diagnosis of bipolar affective disorder was 18.2 (95% CI = (6.70, 49.41)) in those meeting the threshold for likely autism; and 46.89 (95% CI = 9.96, 220.74) in participants meeting the threshold for likely ADHD. Mediation analysis showed that autistic, ADHD and pooled neurodivergent characteristics mediated the link between joint hypermobility and bipolar affective disorder.

This suggests a potential mechanism for affective pathophysiology, through developmental characteristics associated with joint hypermobility. The appreciation of interacting physical and neurodivergent traits to the expression of psychiatric illness has implications for diagnostic formulation, personalised medicine and service design.

Mental health difficulties affect the well-being of doctors and compromise the delivery of healthcare. However, large-scale data on doctors’ mental health needs are limited.

Describe patterns of self-referrals for mental health support among doctors in England and explore associations with demographic factors, speciality, neurodevelopmental and mental health indicators.

Observational study using data from doctors who self-referred for mental health difficulties to a national service in England over a 4-year period. Logistic regression was used to explore associations between speciality and mental health indicators.

Of the 16 815 doctors who self-referred during the study period, 80% were under the age of 49 and 70.6% were female with the two largest ethnicities being 65.1% White and 22.7% Asian. Women were more likely to report higher scores for depression (odds ratio 0.90, 95% CI = 0.84 to 0.97), anxiety (odds ratio 0.78, 95% CI = 0.72 to 0.84) and psychological distress (odds ratio 0.78, 95% CI = 0.70 to 0.87), but males were more likely to screen positive for attention-deficit hyperactivity disorder (ADHD) symptoms. Doctors in general practice accounted for 46.3% of referrals. Compared with them, doctors in most other specialities had higher odds of elevated mental health scores across all measures, including ADHD.

The findings highlight a significant mental health burden among self-referring doctors, particularly for females and doctors in non-general practice specialities. Tailored and easily accessible support strategies that account for both demographic and professional contexts are essential to address the diverse mental health needs of the medical workforce.

Attention-deficit hyperactivity disorder (ADHD) in childhood is associated with various adverse long-term outcomes.

We aimed to examine the independent associations between ADHD symptoms at age 14–16 years and long-term mental health and psychosocial functioning outcomes in a 40-year birth cohort study.

Study members from the Christchurch Health and Development Study, a population-based New Zealand birth cohort study (N = 1265 at birth) were followed to age 40 years. Generalised estimating equations were used to model associations between ADHD symptoms at age 14–16 years and outcomes at age 18–40. Adjusted models were fitted to account for confounding by antecedent individual and familial risk factors, and coexisting symptoms of conduct disorder or oppositional defiant disorder.

Adolescents in the highest quartile for ADHD symptoms at age 14–16 years were at elevated risk of substance use disorder, depression, suicidal ideation, criminal offending and unemployment across early adulthood. They also had lower income, home ownership, relationship stability and living standards. The size of these associations attenuated after adjusting for confounding factors and the effect of coexisting conduct disorder and oppositional defiant disorder. However, in adjusted models, ADHD symptoms remained associated with elevated odds of substance use and criminal offending outcomes, with odds ratios ranging from 1.4 to 1.6.

Higher levels of adolescent ADHD symptoms are associated with substance use problems and criminal offending in adulthood. Long-term secondary prevention activities are needed to detect and manage coexisting problems among adults with a history of ADHD.