A look at “Autism spectrum traits in adults with attention-deficit/hyperactivity disorder (ADHD): a hidden multifaceted phenotype marked by affective comorbidity, emotional dysregulation, and chronobiological disturbances” by Giulio Emilio Brancati, Ugo De Rosa, Anna Magnesa, Irene Cocciaro, Elena Costagli, Anna Iriti, Berenice Rimoldi, Matteo Vedovelli, Pierpaolo Medda, Elisa Schiavi and Giulio Perugi (2025)
ADHD and autism used to be thought of as separate stables, and for years diagnostic manuals didn’t even allow both diagnoses at once. Now we know they often share a paddock. Many people describe themselves as “AuDHD”. This Italian study asks what happens when adults with ADHD also carry autistic traits.
What they found
The researchers worked with 105 adults with ADHD at a hospital psychiatry clinic in Pisa. Everyone completed the Autism-Spectrum Quotient (AQ), a widely used screening questionnaire, along with assessments of mood, anxiety, emotional regulation, personality, temperament and sleep rhythms.
About one in five (22%) screened positive for autistic traits. Compared with the rest, this group:
- Was more often female, which surprised the researchers, since autism is traditionally diagnosed more often in men.
- Came to clinical attention later in life, despite having more complex needs.
- Had higher rates of mood and anxiety conditions, particularly social anxiety and cyclothymia, which involves frequent mood ups and downs.
- Experienced more intense ADHD traits and emotional dysregulation.
- Had more disrupted body clocks, being more likely to be “night owls” with irregular sleep and daily rhythms.
- Was less likely to have problems with cannabis use.
The authors conclude that adults with both ADHD and autistic traits represent a “hidden” group with a more complex picture, who may be missed or reach support late.
A grain of glitter ✨
This study is valuable in highlighting a group who often fall through the cracks, and its finding about women chimes with what many late-diagnosed AuDHD women report. But the evidence is preliminary, as the authors acknowledge.
Only 23 people screened positive, which is a small group on which to base comparisons across dozens of measures. With that many comparisons, some differences may be flukes. The AQ is a screening tool, not a diagnosis, and it can be a fairly blunt instrument. Some of its questions about social situations may pick up social anxiety as well as autistic traits, which may partly explain why the two travelled together here. The participants also came from a specialist hospital clinic, so they’re likely to have more complex needs than average.
The language leans clinical, with phrases like “neurodevelopmental burden” and “pathological personality traits”, which may jar with readers who see their neurotype as a difference rather than a disorder.
Why this matters
If you have an ADHD diagnosis but have always felt it doesn’t quite explain everything, such as the social exhaustion, the need for routine, or sensory overwhelm, it may be worth exploring whether autistic traits are part of your picture too. Understanding the full shape of your neurotype can help you find support that fits, and it can make sense of experiences that previously felt confusing or isolating.
Some unicorns have a horn and wings. It’s not too much; it just means you need a slightly bigger stable.