Prevalence and Clinical Impact of Emotional Dysregulation in Adults with Attention-Deficit/Hyperactivity Disorder: A Retrospective Study from a Specilized Outpatient Clinic

Background Emotional dysregulation is increasingly recognized as a salient clinical feature in adults diagnosed with attention-deficit/hyperactivity disorder (ADHD). However, the mechanism underlying its prevalence and association with symptom severity, psychiatric comorbidities, and functional impairment are not yet fully understood. This study aimed to (I) determine the prevalence of an emotionally dysregulated adult ADHD subphenotype, (II) assess symptom severity, (III) assess comorbidity patterns, and (IV) examine relevant sociodemographic characteristics. Methods This retrospective cross-sectional study analyzed data from 749 adults diagnosed with ADHD in a specialized outpatient clinic. Emotional dysregulation was assessed via all the items of the Wender-Reimherr Adult Attention Deficit Disorder Scale, and latent class analysis was used to identify distinct subphenotypes. Symptom severity, psychological distress, depressive symptoms, and substance use were assessed via standardized self-report instruments. Sociodemographics and psychiatric comorbidities were analyzed via descriptive statistics and inferential tests. Results Emotional dysregulation was present in nearly 61% of the participants. The emotionally dysregulated subphenotype had significantly greater levels of symptom severity, general distress, depressive symptoms, and substance use. They also had a higher mean number of psychiatric comorbidities, particularly substance use disorders. Sociodemographic variables did not differ significantly between groups, although descriptive patterns suggested increased educational and occupational challenges in ADHD patients with emotional dysregulation. Conclusions The high prevalence of emotional dysregulation and its association with increased symptom burden and comorbidities support its clinical relevance in adults with ADHD. Routine assessment of emotional dysregulation could improve diagnostic accuracy and inform personalized treatment strategies. Targeted interventions addressing emotion regulation difficulties may help reduce psychological distress and improve functional outcomes. Further research should investigate longitudinal outcomes and evaluate the effectiveness of specific therapeutic approaches. Trial registration Clinical trial number not applicable