Establishing the Relationship Between Attention Deficit Hyperactivity Disorder and Emotional Facial Expression Recognition Deficit: A Systematic Review

Objective: In this review, we examined if there is a deficit in facial recognition of emotion (FER) in children, adolescents, and adults with attention deficit hyperactivity disorder (ADHD). Background: Emotional regulation is impaired in ADHD. Although a facial emotion recognition deficit has been described in this condition, the underlying causal mechanisms remain unclear. Methods: The search was performed in six databases in September 2022. Studies assessing children, adolescents, or adults with isolated or comorbid ADHD that evaluated participants using a FER task were included. Results: Twelve studies out of 385 were selected, with participants ranging in age from 6 to 37.1 years. A deficit in FER specific to ADHD, or secondary to comorbid autism spectrum disorder, anxiety, and oppositional symptoms, was found. Conclusions: There is a FER deficit in patients with ADHD. Adults showed improved recognition accuracy, reflecting partial compensation. ADHD symptoms and comorbidities appear to influence FER deficits.