Co-occurring anxiety disorders and cognitive performance in children and adolescents with attention-deficit/hyperactivity disorder: A retrospective chart review

Prior findings on anxiety comorbidity and cognition in youth with ADHD are mixed. We tested whether co-occurring anxiety disorders relate to differences in selected cognitive outcomes.
Retrospective chart review of 175 treatment-naïve patients aged 6–18 years with primary ADHD (ADHD-only n = 114; ADHD+anxiety n = 61) evaluated 2020–2025 in Turkey. Anxiety disorders (GAD, separation anxiety, social or specific phobia) were diagnosed clinically (DSM-5) and supported by K-SADS-PL screening. Outcomes were grade-standardized oral reading speed, Trail Making Test (TMT) A/B time and errors, and WISC-R full-scale, verbal, and performance IQ. Group differences were tested with (M)ANCOVA adjusting for age; Holm–Bonferroni controlled family-wise error.
The ADHD+anxiety group was older and had higher clinician-rated global severity (CGI-S). After age adjustment and correction, no group differences were observed in reading speed or TMT outcomes. Verbal IQ was nominally higher in the comorbid group but did not remain significant after correction.
In this clinic-based sample, anxiety comorbidity was not associated with poorer processing speed or cognitive flexibility on this battery.