Depressed or Disengaged? Disentangling Cognitive Disengagement Syndrome, ADHD, and Depression in Adults

This study examined the associations between cognitive disengagement syndrome (CDS), ADHD, and depression in adults to clarify patterns of comorbidity and inform efforts to establish the nosological status of CDS. In addition, the latent structure of adult CDS symptoms was examined, and the clinical relevance of empirically derived CDS dimensions was evaluated.

Clinically referred adults completed self-report measures of CDS and depressive symptoms and were assessed for ADHD, anxiety, and depression using multi-informant diagnostic procedures. Exploratory factor analysis was conducted to evaluate the dimensional structure of CDS symptoms. Group comparisons examined differences in depressive symptom severity across diagnostic groups, and correlational analyses evaluated associations between CDS factor scores and depression.

Exploratory factor analysis supported a two-factor structure of CDS symptoms reflecting cognitive complaints and lethargy. Individuals with CDS reported significantly greater depressive symptom severity than individuals with ADHD. Both CDS factors were significantly associated with depressive symptoms, with lethargy demonstrating a stronger association than cognitive complaints.

Findings support CDS as a multidimensional construct in adults that is closely linked to depressive symptomatology. The observed factor structure and its associations with depression suggest that CDS symptoms extend beyond attentional dysfunction alone and may reflect broader internalizing processes. Although CDS was rarely observed in isolation, its distinct symptom profile and pattern of associations differentiate it from ADHD. Further research is needed to clarify whether CDS is best conceptualized as a transdiagnostic process, a cross-diagnostic clinical syndrome, an internalizing disorder, or an attentional disorder.