Intensive care unit (ICU) admission can represent a relevant physical and psychological burden in patients, leading to long-term mental health problems such as anxiety, depression, and post-traumatic stress disorder (PTSD). The present study aimed to systematically assess the physical and psychiatric (particularly depressive, anxiety, and post-traumatic stress) symptoms in patients discharged from the ICU of a major University Hospital in Italy (Pisa) 6 months earlier, with particular, attention to differences between patients who developed PTSD and those who did not. The strength of this study is to increase the understanding of PTSD, depressive and anxiety symptoms; in particular, their correlations with the physical sequalae. Subjects were assessed six months after ICU discharge by means of the Glasgow Outcome Scale-Extended (GOS-E), Quality of Life after Brain Injury (QOLIBRI), the 3-level version of the EQ-5D (EQ-5D-3L) questionnaire, Impact of Event Scale-Revised 22-item (IES-R), Patient Health Questionnaire, 9-Item Version (PHQ-9), and Generalized Anxiety Disorder Assessment, 7-item version (GAD-7). The results of this study showed, in accordance with the IES-R, a moderate prevalence of PTSD (25.3%) six month after ICU discharge and a statistically significant higher prevalence (63.6%, p = 0.039) of moderate and severe disabilities in the PTSD group compared to the no-PTSD group, as well as higher depressive and anxiety symptoms and other psychiatric sequelae, suggesting the need for accurate long-term psychiatric assessment in ICU survivors.

Background/Objectives: Sex differences in adult attention-deficit/hyperactivity disorder (ADHD) remain insufficiently characterized, particularly in clinically referred samples assessed through multidimensional and multi-informant approaches. This study investigated sex differences in clinical presentation, psychiatric comorbidity, psychometric features, and ADHD severity in adults with ADHD, with a specific focus on emotional dysregulation and rating-source effects. Methods: A total of 212 consecutively recruited adults with ADHD, including 93 females and 119 males, underwent a comprehensive assessment at a tertiary referral service. Sex differences were examined across sociodemographic, clinical, comorbidity, functional, and psychometric domains. ADHD severity was assessed using both self-rated and observer-rated measures. Regression, mediation, and repeated-measures mixed-effects models were fitted to examine the role of emotional dysregulation in the association between sex and ADHD severity. Results: Females showed a higher frequency of predominantly inattentive presentation; higher rates of mood, anxiety, and eating disorders; and more pronounced emotional dysregulation, affective temperamental traits, personality-related impairment, and biological rhythm disturbances. Observer-rated ADHD severity did not differ by sex, while females reported higher self-rated ADHD severity. Emotional dysregulation was associated with both observer-rated and self-rated ADHD severity, with a stronger association for self-rated symptoms. Mediation analysis showed a significant indirect effect of female sex on self-reported ADHD severity through emotional dysregulation, accounting for 79.4% of the total association. Mixed-effects models further indicated that sex differences in ADHD severity varied according to rating source and persisted, although attenuated, after accounting for emotional dysregulation. Conclusions: Adult females with ADHD showed a different clinical profile, characterized by greater internalizing comorbidity, emotional dysregulation, personality-related impairment, and biological rhythm disturbances. Emotional dysregulation accounted for a substantial part of the higher self-reported ADHD severity observed among females, while rating-source effects suggested that sex differences in adult ADHD may partly depend on how symptom severity is assessed.