Adhd and hypersexual behaviors: The role of impulsivity, depressive feelings, hypomaniacal symptoms and psychotic prodromes

Introduction Numerous studies in the literature correlate hypersexual symptomatology and attention deficit hyperactivity disorder (ADHD). The present study aimed to investigate this correlation and the eventual mediation role of impulsivity. Methods We recruited through an online platform a sample of 309 subjects (mean age = 34.5, SD = 15.4; females: 67.31 %); then, a sociodemographic questionnaire, together with validated psychometric scales for assessing hypersexuality, ADHD symptomatology, depression, hypomania, prodromal symptoms of psychosis and impulsivity were administered. Results We found a significant association between ADHD symptomatology and hypersexuality symptoms (β = 0.459; p < 0.001). We found a significant predictive model of hypersexuality related to age, gender, depression, hypomanic symptoms, psychotic prodrome, ADHD symptomatology, and impulsivity (adjusted R2 = 0.311; p < .001). Moreover, we found that impulsivity is a significant mediator of the relationship between ADHD and hypersexuality when we considered only the hyperactive-impulsive ADHD subscale (β = 0.103; p = 0.006). Depression and psychotic prodromes have been shown a more relevant mediator effect on the relationship between ADHD and hypersexuality. Conclusions Our results clarified the well-known relationship between ADHD and hypersexuality, suggesting a significant mediating role of psychotic prodromes and depression in this association. This finding further reinforces the view of hypersexual symptomatology not as a disorder but rather as a psychopathological manifestation of distress, a maladaptive coping strategy that individuals enact due to increased difficulties experienced in the environment. The role of impulsivity as a predictor has shown mixed results, revealing that difficulties in impulse control may play a more marginal role, compared to depressive symptomatology and psychotic prodromes, in determining hypersexuality.