The Review of Mechanisms and Intervention Methods for Comorbidity of ADHD and Anxiety

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) and anxiety disorders represent significant psychological conditions that frequently co-occur, presenting substantial challenges for clinical diagnosis and treatment. However, critical gaps persist in the clinical application of mechanistic understanding and intervention strategies for this comorbidity. This review systematically examines the potential mechanisms underlying ADHD-anxiety disorder comorbidity across four dimensions: neural circuitry, neurochemical dysregulation, hypothalamic-pituitary-adrenal (HPA) axis dysfunction, and genetic predisposition. It indicates that prefrontal-limbic system dysfunction, imbalances in key neurotransmitters, stress-related HPA axis dysregulation, and genetic variants such as ADORA2A and DRD2 may play pivotal roles in the comorbid mechanism. The review also evaluates the strengths and limitations of current interventions, including pharmacological treatment and cognitive behavioral therapy, outlines challenges in clinical practice, and suggests directions for future therapeutic approaches. Overall, this synthesis advances the clinical understanding of ADHD-anxiety comorbidity mechanisms and supports progress toward precision assessment and individualized intervention strategies.