Ömer Bayırlı

Introduction: This case–control study examined social barriers in adults with ADHD compared to non‐neurodivergent adults, focusing on autistic traits, cognitive/affective empathy, theory of mind (ToM), and social anxiety/avoidance. Methods: A total of 142 adults with ADHD and 104 non‐neurodivergent groups were assessed using the following self‐report measures: the Adult ADHD Self‐Report Scale, the Hospital Anxiety Depression Scale, the Autism Spectrum Quotient, the Empathy Quotient, and the Liebowitz Social Anxiety Scale. ToM was evaluated using the Reading the Mind in the Eyes Test. Additionally, psychiatric interviews were conducted, incorporating diagnostic evaluation via the Structured Clinical Interview for DSM‐5 Disorders—Clinician Version, along with collection of sociodemographic and clinical data, and documentation of real‐life narratives of social struggles to contextualize and deepen the interpretation of the quantitative findings. Results: Adults with ADHD exhibited significantly higher levels of autistic traits and social anxiety/avoidance, along with lower cognitive and affective empathy scores, compared to controls, while ToM abilities did not differ significantly between groups. Moreover, regression analyses indicated that challenges in social skills and communication, low cognitive empathy, heightened affective empathy, and difficulties in attention switching accounted for variance in social anxiety/avoidance, independent of confounding sociodemographic and clinical factors, including the presence of co‐occurring psychiatric conditions and the severity of ADHD, depression, and anxiety symptoms. Conclusion: While adults with ADHD exhibit intact basic ToM abilities, challenges in social‐cognitive processes are associated with their social barriers. Targeted interventions such as social skills training, executive function coaching, and anxiety management may improve social outcomes and quality of life, as also highlighted by the real‐life narratives—although further longitudinal, multi‐method research is warranted.

Individuals with Attention-Deficit Hyperactivity Disorder (ADHD) are at an increased risk of suicidal ideation and attempts compared to the general population. However, the mechanisms underlying suicidal behaviors in this group remain poorly understood. The role of childhood trauma, which frequently co-occurs with ADHD, and emotional dysregulation in suicidal behaviors remains unclear. This study employs a case-control design to investigate the impact of childhood trauma and emotional dysregulation on suicidal tendencies in adults with ADHD. A total of 160 adults diagnosed with ADHD who presented to the Adult Neurodevelopmental Disorders Clinic at Selçuk University, along with 107 typical controls, were included in the study. Participants were assessed using the Structured Clinical Interview for DSM-5, Adult ADHD Self-Report Scale, Suicidal Ideation Scale, Childhood Trauma Questionnaire, and the Difficulties in Emotion Regulation Scale—Short Form. Regression and mediation models were conducted to examine factors influencing suicidal tendencies, controlling for sociodemographic and clinical variables. Compared to controls, individuals with ADHD exhibited significantly higher levels of suicidal ideation, childhood trauma, and emotional dysregulation. Regression analysis revealed a positive association between childhood trauma, emotional dysregulation, and suicidal ideation. However, ADHD symptoms did not directly contribute to increased suicidal ideation; rather, their effect was mediated through childhood trauma and emotional dysregulation. Additionally, the presence of depression was significantly associated with both suicide attempts and suicidal ideation. These findings suggest that childhood trauma and difficulties in emotion regulation play critical roles in suicidal ideation among individuals with ADHD. In addition to depression treatment, comprehensive interventions targeting childhood trauma and emotional dysregulation may serve as promising strategies for reducing suicidal behaviors.

This study aims to assess the mediating effect of childhood trauma and dissociative experiences on the relationship between self-reported ADHD symptoms during childhood and adulthood in two separate cross-sectional studies. In Study 1, undergraduate students completed an online survey including a sociodemographic form, the Adult ADHD Self-Report Scale (ASRS), the Wender Utah Rating Scale (WURS), the Childhood Trauma Questionnaire (CTQ), and the Dissociative Experiences Scale (DES). Data from 1,148 participants were analyzed using descriptive statistics and mediation analysis. In Study 2, sociodemographic, clinical, and diagnostic data from 202 adults with ADHD, followed at the Adult Neurodevelopmental Disorders Clinic at Selçuk University, were analyzed. Diagnostic evaluations were conducted using the Structured Clinical Interview for DSM-5 Clinician Version. Clinical data included age, gender, years of education, comorbid conditions, and current ADHD medication use. The same self-report scales (ASRS, WURS, CTQ, and DES) were administered in both studies. The two samples differed significantly in terms of clinical characteristics and self-reported symptoms. Current ADHD symptoms were not only directly associated with childhood ADHD symptoms but also indirectly associated with them through increased childhood trauma and dissociative experiences, independent of demographic and clinical confounding factors in both studies. The pathway involving childhood trauma and dissociation may partially mediate the persistence of ADHD symptoms from childhood to adulthood in both undergraduate and adult ADHD samples. Longitudinal clinical studies are needed to better understand how the childhood trauma and dissociation pathway may influence the persistence of ADHD symptoms as individuals age, potentially extending into adulthood.

Introduction: Our study aimed to compare the sociodemographic, diagnostic, clinical, and self-report scale data of adults diagnosed with ADHD in childhood/adolescence versus adulthood and to identify risk factors associated with delayed/missed diagnosis for ADHD. Method: Sociodemographic, clinical, and diagnostic data of 214 adults with ADHD, followed at the Adult Neurodevelopmental Disorders Clinic, Selçuk University, between January 2022 and January 2024, were analyzed. The diagnostic evaluations were made using the Structured Clinical Interview for DSM-5 Clinician Version. Clinical data included age, gender, years of education, alcohol/substance use, diagnosis age, and current medication use for ADHD. Data collected from self-report scales included both ADHD-related measurements and comorbidity-related measurements. Results: The findings revealed that only 34.4% ( n = 74) of sample received a formal ADHD diagnosis during childhood/adolescence. Adults diagnosed with ADHD in adulthood were older and had higher education levels, more severe ADHD symptoms, and increased maladaptive daydreaming (MD) scores, compared to those diagnosed in childhood or adolescence. Logistic regression analysis indicated that the severity of MD was associated with being in the group diagnosed with ADHD in adulthood while controlling for other significant parameters from bivariate analyses, such as age, years of education, and current medication use for ADHD. Finally, analyses conducted separately in both groups showed that: (1) increased MD severity was a predictor of higher ADHD symptoms in those diagnosed in adulthood, but not in those diagnosed in childhood/adolescence, and (2) MD severity had a stronger correlation with ADHD symptoms, the number of comorbid psychiatric disorders, and symptoms of excessive mind wandering, depression, and anxiety in those diagnosed in adulthood compared to those diagnosed in childhood/adolescence. Conclusion: MD may delay ADHD diagnosis until adulthood by masking and compensating ADHD symptoms and delay in referral to mental health professionals, and it might also be a predictive symptom for recognizing ADHD in adults who have never been diagnosed; however, longitudinal studies are needed to confirm this.

Objective: Digital technologies aid in remote patient monitoring, data collection, psychoeducation, self-help applications, disease recognition, and awareness enhancement. However, literature on the utilization of digital technologies among psychiatric patients is scarce. This study aimed to assess the prevalence of digital technology usage among patients attending psychiatric outpatient clinics and compare usage patterns across different diagnoses. Materials and Methods: Between September-November 2023, 500 patients who applied to Selcuk University Faculty of Medicine Psychiatry Outpatient Clinic as outpatients and volunteered to participate in the study were included in the study. After the psychiatric interviews were completed, a questionnaire was filled out asking about the characteristics of the use of mobile technologies, internet, social media, and health applications. Results: Of the study group, 69.4% were female (n=347) and the mean age was 33.9 (±13.01) years. The educational status of 50.4% of the participants was university or master's degree. While 96% of the participants used smartphones, 16% used wearable technology (n=80). Internet usage rate was 94.8% and social media usage rate was 91%. When 251 people who did not use any health application but would like to use one were asked which features they would like to have in the application they would like to use, 78.8% stated that they would like to create an appointment, 67.7% would like an appointment time reminder, 59.7% would like drug side effect query, 55.7% would like their physician to have access to their health information, and 54.9% would like online psychotherapy. Conclusions: The prevalence of smartphone and internet use among patients applying to psychiatry is similar to the national population. There is an unmet need in terms of health applications for the psychiatric patient group. When looking at the desired characteristics of health applications, it should be taken into account that there are different demands in psychiatric diagnosis groups.