Time after time: failure to identify and support females with ADHD – a Swedish population register study
Open accessAbstract
Background: Attention deficit hyperactivity disorder (ADHD) is associated with risk taking and negative health‐related outcomes across the lifespan. Due to delay in referral and diagnostics, young females with ADHD may not be identified, nor appropriately supported by adequate interventions. Methods: A total of 85,330 individuals with ADHD, all of whom were residents in Stockholm County between January 01, 2011, and December 31, 2021, were included as participants in this population‐based, cross‐sectional cohort study. Population controls ( n = 426,626) were matched by age, sex, and socioeconomic status (SES). Data was obtained from Regional Healthcare Data Warehouse of Region Stockholm (VAL) in Stockholm County. Exposure was ADHD‐index, defined as the first record of either ICD‐10 F90 diagnosis and/or ATC‐code for stimulant or non‐stimulant ADHD‐medication during the study period. Primary outcome was age at ADHD‐index. Secondary outcome measures were psychiatric comorbidity, pharmacological treatment, and health care utilization, prior to and after ADHD‐index. Results: Females were older at ADHD‐index (23.5 years, SD 13.8) compared to males (19.6 years, SD 13.9, 95% CI of difference 3.74–4.11). Overall, females with ADHD showed higher rates of psychiatric comorbidity, pharmacological treatment, and health care utilization, compared to males with ADHD and female controls. Conclusions: Females with ADHD receive diagnosis and treatment for ADHD approximately 4 years later than males. They have a higher burden of comorbid psychiatric conditions and health care utilization, compared to males with ADHD and female controls, both prior to and after ADHD‐index. To prevent long‐term adverse consequences for females with ADHD, methods, and tools for early diagnosis and treatments that mitigate personal suffering and societal burden are warranted.
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Women are more often misdiagnosed and diagnosed later than men with ADHD.
“However, women are more often misdiagnosed [23] and diagnosed later [85] than men with ADHD.”
From A Female-Specific Treatment Group for ADHD—Description of the Programme and Qualitative Analysis of First Experiences (2024) · cites this paper as [85]
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- Authors
- Skoglund, C., Sundström Poromaa, I., Leksell, D., Ekholm Selling, K., Cars, T., Giacobini, M., Young, S., & Kopp Kallner, H.
- Affiliations
- Uppsala University (SE)
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
- Smart Psykiatri AB Stockholm Sweden
- Sence Research AB Uppsala Sweden
- Karolinska Institutet (SE)
- Reykjavík University (IS)
- Department of Clinical Sciences at Danderyd Hospital Karolinska Institutet Stockholm Sweden
- Corresponding author
- Skoglund, Charlotte
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2023-11-28
- Volume
- 65
- Issue
- 6
- Pages
- 832-844
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W4389109678
- Cited by
- 77
- References
- 41
- Citations by year
- 2026: 41 · 2025: 27 · 2024: 9
- FWCI
- 15.61
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Opin vísindi (Opin vísindi) (submittedVersion, cc-by-nc-sa)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- Funders
- Eli Lilly and Company
- Gedeon Richter
- Uppsala Universitet
- H. Lundbeck A/S
- UCB Pharma
- Cilag
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- attention deficit hyperactivity disorder, delayed diagnosis, age at diagnosis, psychiatric comorbidity, ADHD medication, health care utilization, sex differences, early diagnosis, Stockholm County
- MeSH terms
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Child, Cross-Sectional Studies, Female, Humans, Male, Patient Acceptance of Health Care, Registries, Sex Factors, Sweden, Comorbidity, Young Adult, Delayed Diagnosis
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