Retrospective childhood attention-deficit/hyperactivity disorder traits and their differential associations with mood disorder presentations in adulthood.

BACKGROUND

Childhood symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) often persist in adulthood and overlap considerably with mood disorder presentations. This study examines how specific childhood ADHD traits relate to distinct clinical characteristics in adults with mood disorders.

METHODS

We analyzed data from 755 adults diagnosed with major depressive disorder (n = 287) or bipolar disorder (n = 468). Participants retrospectively reported childhood ADHD traits using the 25-item Wender Utah Rating Scale. We mapped associations between childhood ADHD total score and three childhood ADHD traits (Impulsivity/Behavioral Problems, Inattentiveness/School Problems, Self-esteem/Negative Mood) and a comprehensive set of clinical variables, including depression, anxiety, affective temperament, emotional instability, adult ADHD symptoms, emotion regulation skills, childhood trauma, interpersonal sensitivity, resilience, problematic alcohol use. Partial correlations were used to identify initial links, followed by the path analysis to further explore these associations.

RESULTS

Childhood ADHD traits showed its strongest associations with trait-based mood instability, childhood trauma exposure, adult ADHD symptoms, and interpersonal sensitivity. Among mood temperaments, depressive temperament showed the strongest association, while hyperthymic the weakest. Emotion regulation skills showed minimal association. No significant subgroup differences were found among diagnostic groups or sexes according to multigroup SEM. Dimensionally, Self-esteem/Negative Mood uniquely predicted greater depressive and anxiety symptoms, behavioral inhibition, higher interpersonal sensitivity, lower resilience, and problematic alcohol use. Inattentiveness/School Problems was the strongest and most consistent predictor of adult ADHD symptoms. Impulsivity/Behavioral Problems selectively related to irritable temperament, behavioral activation, and lower interpersonal sensitivity.

CONCLUSIONS

Childhood ADHD traits show distinct, dimension-specific associations with adult mood disorder phenotypes. Viewing ADHD as distinct traits may guide more personalized treatment strategies.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00406-026-02251-9.