The effect of intranasal oxytocin on theory of mind in children with attention deficit/hyperactive disorder

Attention Deficit/Hyperactivity Disorder (ADHD) is associated with impairments in social cognition and theory of mind (ToM), potentially mediated by alterations in dopaminergic and oxytocinergic pathways. This pilot, proof-of-concept, randomized controlled trial examined the effects of intranasal oxytocin (IN-OT) on ToM and social cognition in children with ADHD. Eight participants (6 males, 2 females), all diagnosed with ADHD, were randomly assigned to receive a single dose of IN-OT or placebo in a double-blind, crossover design. Participants completed assessments of ToM, social cognition, and executive function at baseline and post-treatment. In the second phase, IN-OT was administered alongside prescribed stimulant medication. Statistical analysis was conducted by calculating the Reliable Change Index (RCI > 1.96) and assessing whether participants returned to a functional distribution (SD < 2.0). Results demonstrated improvements in mean reaction time and response consistency in tasks assessing ToM and emotion recognition following OT administration. No adverse effects were reported. While preliminary, this study suggests a possible role of IN-OT in enhancing social cognition and ToM in children with ADHD. Given the study's small sample size, larger trials are needed to confirm these effects and explore IN-OT as a potential adjunctive therapy for ADHD-related social deficits.