ADHD Comorbidity in Women With Depression and Anxiety: Prevalence, Clinical Features and Hyperfocus Dynamics

Abstract

Objective: This study investigated ADHD comorbidity and clinical features, including hyperfocus, in women with depressive or anxiety disorders, addressing the diagnostic complexities arising from symptom overlap and the underdiagnosis of ADHD in this population. Methods: Female patients from outpatient psychiatric clinics (n = 170) were assessed using the Beck Depression Inventory and Beck Anxiety Inventory. Participants meeting threshold scores underwent further evaluation with the Wender-Utah Rating Scale, Hyperfocus Scale, and Adult ADHD DSM-IV-Based Diagnostic Screening Scale, complemented by structured clinical interviews. Results: ADHD was identified in 19.6% (n = 33) of patients, 45.5% (n = 15) of whom were previously undiagnosed. ADHD was most prevalent in patients with social anxiety disorder (46.4%) and double depression (40.6%). In non-ADHD participants, attention deficit correlated positively with depression (r = 0.236, p = 0.005), hyperactivity with anxiety (r = 0.187, p = 0.029), and hyperfocus with ADHD scores (r = 0.434, p < 0.001; r = 0.292, p = 0.001); no such correlations were seen in the ADHD group. Conclusion: ADHD is common and frequently overlooked in women presenting with depression or anxiety. While hyperfocus is a relevant clinical feature, it is not diagnostic alone and correlates with ADHD symptoms in the absence of ADHD. Clinicians should conduct thorough screenings for ADHD and carefully interpret hyperfocus within the broader clinical context to ensure accurate diagnosis and timely, appropriate treatment.