Miss. Diagnosis: A Systematic Review of ADHD in Adult Women
Open accessAbstract
OBJECTIVE: The aim of this review was to explore the impact of living with undiagnosed ADHD and adult diagnosis on women. METHOD: A systematic literature search was completed using three databases. Eight articles were considered relevant based on strict inclusion criteria. Thematic analysis was used to analyze the results of the articles. RESULTS: Four key themes emerged: Impacts on social-emotional wellbeing, Difficult relationships, Lack of control, and Self-acceptance after diagnosis. CONCLUSION: This knowledge can be used to advance the understanding of ADHD in adult women and the implications for late diagnosis in women.
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There is a dire need for female-specific treatment options for ADHD expressed by many, including patients.
“We developed this female-specific treatment option in response to the dire need expressed by many [1,17,19,23,24,25,26,28,41,55,85], including patients.”
From A Female-Specific Treatment Group for ADHD—Description of the Programme and Qualitative Analysis of First Experiences (2024) · cites this paper as [17]
The Implications section (page unavailable) describes disparities in diagnosis and treatment for women and girls and warns that delayed diagnosis may prevent access to treatment. It does not say that many people, including patients, expressed a dire need for female-specific treatment options. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSocial difficulties are important for women with ADHD.
“We decided on a group programme because of the importance of social difficulties for women with ADHD [10,17].”
From A Female-Specific Treatment Group for ADHD—Description of the Programme and Qualitative Analysis of First Experiences (2024) · cites this paper as [17]
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Embracing neurodiversity-informed dentistry. Part five: Diverse minds in the dental profession
Murphy, J., Andrews, F., & Morgan, M. Z. (2023) · BDJ Team · doi:10.1038/s41407-023-2026-8 · Cited by 5 · see citing works
Sandland, B. (2025) · Neurodiversity · doi:10.1177/27546330251394516 · Cited by 4 · see citing works
“Being diagnosed late, was an important factor to the experiences all participants shared (Attoe & Climie, 2023), as this led to growing up with an awareness of being different but without an understanding as to why.”
Paying Attention: Female ADHD Students Learning in Graduate School
Devol, T. M., & Sun, Q. (2023) · Adult Education Quarterly · doi:10.1177/07417136231217473 · Cited by 4 · see citing works
“In a systematic literature review, women with ADHD experienced low self-esteem; struggled with social relationships and emotional reactivity; and developed dysfunctional coping strategies (Attoe & Climie, 2023).”
BackgroundAbsent or Hidden? Hyperactivity in Females With ADHD
Wettstein, R., Navarro-Ovando, V., Pirgon, E., Kroesen, J., Wettstein, K., Kroesen, H., Mâthot, R., & Dumont, G. (2024) · Journal of Attention Disorders · doi:10.1177/10870547241273152 · Cited by 3 · see citing works
“Delaying or even missing an ADHD diagnosis can have long lasting implications in self-perception and well-being that persist into adulthood (Attoe & Climie, 2023) and increase the risk of developing other comorbid psychiatric disorders that are associated with ADHD (Dalsgaard et al., 2015; Quinn &…”
Toole, K. P., & Frank, C. (2024) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2024.07.013 · Cited by 4 · see citing works
ADHD and Career Success: Barriers, Facilitators, and Future Research Directions
Samosh, D. S., Lilius, J. M., & Atwood, K. (2024) · Palgrave studies in equity, diversity, inclusion, and indigenization in business · doi:10.1007/978-3-031-55072-0_12 · Cited by 4 · see citing works
Loos, E., Sekar, S., Rosin, C., Navarini, A. A., Schwale, C., Schaefert, R., & Mueller, S. M. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14051774 · Cited by 3 · see citing works
“Women with ADHD may also experience anxiety, low self-esteem [67,68], reduced social– emotional well-being, difficulty in relationships, and feelings of a lack of control [69].”
ADHD Identity: How Age, Race, and Socioeconomic Status Shape Rejection or Acceptance
Pyland, C. P., Zoet, Z., Holmes, M., Davis, H., Rivers, A. S., & Mollen, D. (2025) · Identity · doi:10.1080/15283488.2025.2510266 · Cited by 3 · see citing works
Brown, L. E., Mustajbegovic, L., Boyes, M. E., & MYERS, B. J. (2025) · Neurodiversity · doi:10.1177/27546330251351057 · Cited by 3 · see citing works
“…in the context of ADHD include: an understanding of ADHD (Ginapp et al., 2023), self-awareness (Becker et al., 2023; Miller, 2017), self-acceptance (Attoe & Climie, 2023; Beaton et al., 2022; I. L. Rasmussen et al., 2022), acceptance of disability (Botha & van der Westhuizen, 2023; Zapata &…”
Gender Fairness of Machine Learning Algorithms for Pain Detection
Green, D., Shang, Y., Cheong, J., Liu, Y. M., & Güneş, H. (2025) · International Conference on Automatic Face and Gesture Recognition · doi:10.1109/fg61629.2025.11099137 · Cited by 3 · see citing works
“It is essential to scrutinize the decisions made by automated processes, since biases can exacerbate existing disparities in healthcare systems [2], [45].”
de Melo, I. H., & França, G. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1813029 · Cited by 3 · see citing works
Women’s brain health and brain capital
Castro‐Aldrete, L., Greenfield, M., Smith, E., Eyre, H. A., Barbato, M., Pérez, L., & Chadha, A. S. (2025) · Nature Mental Health · doi:10.1038/s44220-025-00406-6 · Cited by 3 · see citing works
“Furthermore, while autism spectrum disorders and attention deficit hyperactivity disorder are more prevalent among male individuals, female individuals present with different symptoms, which has historically led to underdiagnosis 18,19 .”
‘ I felt like a broken person ’: the experiences of women navigating a late ADHD diagnosis in the UK
Baig, S., & Kahya, H. (2025) · Advances in mental health · doi:10.1080/18387357.2025.2524513 · Cited by 3 · see citing works
Żełabowski, K., Petrov, W., Ślebioda, D., Rusinek, M., Biedka, K., Błaszczyk, K., Wesołowski, M., Wojtysiak, K., Sroka, M., Ratka, Z., et al. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14186470 · Cited by 3 · see citing works
“This phenomenon can be attributed to the observation that, in boys, the most prevalent symptoms—namely, motor hyperactivity and impulsivity—are more pronounced, while in girls, the less noticeable attention deficit is predominant [13,15,16].”
Takaesu, Y., Sato, Y., Iwata, S., Takizawa, P., Miyauchi, H., Ishimoto, Y., & Kondo, T. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1197513 · Cited by 5 · see citing works
Coming to Terms with Our Racecar Brains: Academic Mothers Experiencing Adult Diagnosis of ADHD
Cripe, E. T., LeBlanc, S. S., Eilert, M., & Bernhardt, K. (2024) · Health Communication · doi:10.1080/10410236.2024.2331999 · Cited by 5 · see citing works
Attention Deficit Hyperactivity Disorder and Professional Scepticism
Khaksari, N. S., Hesarzadeh, R., Dashtbayaz, M. L., Bazrafshan, A., & Saeedi, A. (2025) · Australian Accounting Review · doi:10.1111/auar.12446 · Cited by 3 · see citing works
Keys, Z., Kieran, A., & Burns, S. (2025) · Emotional and Behavioural Difficulties · doi:10.1080/13632752.2025.2505829 · Cited by 3 · see citing works
“…stresses that females with Attention-Deficit/Hyperactivity Disorder (ADHD) are underrepresented and understudied, potentially leading to under-or mis-diagnosis, and hindering our understanding of the female-specific presentation (Attoe and Climie 2023; Chronis-Tuscano 2022; Young et al. 2020).”
Baby, M., Priya, V., Pallavi, J., Karthik Chand, B., Srinivasan, L., Rana, S., Tawil, S., Haque, S., Ghosh, P., Bhattacharya, P., et al. (2025) · International Journal of Women's Health · doi:10.2147/ijwh.s511297 · Cited by 2 · see citing works
Wang, S., Stewart, T. M., Murray, A., & Rhodes, S. (2025) · Development and Psychopathology · doi:10.1017/s0954579425100461 · Cited by 2 · see citing works
“Such delays may exacerbate their emotional difficulties due to unmet needs and insufficient support during important developmental periods (Attoe & Climie, 2023; Quinn & Madhoo, 2014).”
Cıvan, H. Y., & Berkol, T. D. (2025) · The International Journal of Psychiatry in Medicine · doi:10.1177/00912174251376111 · Cited by 2 · see citing works
“35,38 By narrowing our focus to women with anxiety and depressive disorders, we aim to clarify how ADHD manifests in this subgroup and explore how gendered expressions of the disorder may in fl uence diagnosis.”
Al‐Beltagi, M., Mani, B. S., Hantash, E. M., Zahrani, A. A. A., & Toema, O. (2025) · World Journal of Clinical Pediatrics · doi:10.5409/wjcp.v14.i4.111684 · Cited by 2 · see citing works
Self-Compassion in University Students With ADHD: A Qualitative Exploration
Farmer, G. M., Bayliss, D. M., Finlay‐jones, A. L., & Ohan, J. L. (2026) · Emerging Adulthood · doi:10.1177/21676968261417727 · Cited by 2 · see citing works
“This study, like others, found that many participants had internalised these views and come to see themselves as being of fundamentally poor character — a bad person, rather than a good person with ADHD (Attoe & Climie, 2023; Young et al., 2008).”
Revealing Gaps: Analysis of Nursing Faculty's Awareness of Neurodiverse Diagnoses
Arbour, M. W., & Milazzo, M. C. (2026) · Journal of Nursing Education · doi:10.3928/01484834-20260112-06 · Cited by 2 · see citing works
How Do We Navigate the Conceptual Tension Between Paradigms of ADHD?
Nicholson, T., & Lee, R. P. (2026) · Neurodiversity · doi:10.1177/27546330261433280 · Cited by 2 · see citing works
Hall, S. V., Pangori, A., Tilea, A. M., Schroeder, A., & Zivin, K. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.073 · Cited by 2 · see citing works
Pavy, C. L., Shaw, J. C., Dyson, R. M., Palliser, H. K., Moloney, R. A., Sixtus, R. P., Berry, M. J., & Hirst, J. J. (2024) · Developmental Psychobiology · doi:10.1002/dev.22554 · Cited by 2 · see citing works
Linguistic dynamics: women versus general population in Reddit ADHD discussions
Rahman, M. M. (2024) · Academia Mental Health and Well-Being · doi:10.20935/mhealthwellb7426 · Cited by 1 · see citing works
A Novel ADHD Parenting Program to Improve Parent-Child Attachment: A Mixed Methods Feasibility Study
Brown, L. E., Tallon, M. M., Kendall, G. E., Boyes, M. E., & MYERS, B. J. (2025) · Neurodiversity · doi:10.1177/27546330251340443 · Cited by 2 · see citing works
“These being: an understanding of ADHD (Ginapp et al., 2023), self-awareness (Becker et al., 2023; Miller, 2017), self-acceptance (Attoe & Climie, 2023; Beaton et al., 2022; Rasmussen et al., 2022), acceptance of disability (Botha & van der Westhuizen, 2023; Zapata & Worrell, 2023), self-compassion…”
Stephenson, P., Durand, M., Humphreys, M., & Stewart, A. (2025) · BJPsych Bulletin · doi:10.1192/bjb.2025.35 · Cited by 2 · see citing works
“28 Alternatively, people without additional disease burden may be better able to contain ADHD symptoms; they may place less value on input from a specialist ADHD service.”
Mentalisation, Self-Compassion, and the Psychosocial Impact of ADHD in Adult Women
Witteveen, K., & O’Hara, D. (2025) · Psychotherapy and Counselling Journal of Australia · doi:10.59158/001c.141060 · Cited by 2 · see citing works
Innovative design and modelling to improve sex and gender analysis in clinical trials
Peters, S. A. E., Graham, B. M., Berwanger, O. B., Harris, K., Woodward, M., & Hirst, J. E. (2025) · BMJ · doi:10.1136/bmj-2025-085681 · Cited by 2 · see citing works
Executive Dysfunction and Anxiety in Adolescent Females with ADHD: A Study of Arab Israeli Students
Ghanamah, R., & Khaldi-Mreh, J. (2025) · Disabilities · doi:10.3390/disabilities5040091 · Cited by 2 · see citing works
“While research has traditionally focused on males, females with ADHD frequently exhibit internalizing symptoms, such as anxiety and emotional dysregulation, rather than hyperactivity or impulsivity [11–13].”
Harvey, A., Moreau, C. A., Kumar, K., Huguet, G., Urchs, S. G. W., Sharmarke, H., Jizi, K., Martin, C.-O., Younis, N., Tamer, P., et al. (2024) · Imaging Neuroscience · doi:10.1162/imag_a_00222 · Cited by 3 · see citing works
“It is well known that certain conditions (particularly ASD, ADHD, and SZ) are underrepresented among females, which reflects differences in understanding and diagnosing as well as prevalence ( Attoe & Climie, 2023; Bierer et al., 2022; X. Li et al., 2022; Loomes et al., 2017; Pedersen et al., 2022).”
BackgroundFemale athletes with ADHD: time to level the playing field
Collins, K. (2024) · British Journal of Sports Medicine · doi:10.1136/bjsports-2024-108068 · Cited by 2 · see citing works
Probability of change in diagnosis among adult patients diagnosed with childhood mental disorders
Gazizullin, T. R., & Mendelevich, В. D. (2023) · Neurology Bulletin · doi:10.17816/nb340868 · Cited by 1 · see citing works
Embracing Neurodivergence: Essential considerations in family law practice
Cottingham, M., & Spear, T. (2024) · Family Court Review · doi:10.1111/fcre.12840 · Cited by 1 · see citing works
Dancing Hands: On Neurodivergent Embodied Knowledge
Püschel, A. (2025) · Social Inclusion · doi:10.17645/si.9089 · Cited by 1 · see citing works
MacLean, B., Buissink, P., Louw, V. J., Chen, W., & Richards, T. (2025) · Nutrients · doi:10.3390/nu17050785 · Cited by 1 · see citing works
“As a systemically underappreciated condition in women [8], we wished to further explore the presentation of ADHD symptoms in women and to explore whether HMB and iron deficiency could play a role in symptom development.”
InfluentialJensen-Fogt, T., & Pedersen, C. L. (2025) · Journal of Sex Research · doi:10.1080/00224499.2025.2489771 · Cited by 1 · see citing works
The Significance of Labels: From Shy and Lazy to Autistic and ADHD
Bechsgaard, K. K. (2025) · Ought The Journal of Autistic Culture · doi:10.9707/2833-1508.1221 · Cited by 1 · see citing works
“Being in my Own Skin”: Exploring the Experiences of Indian Women with ADHD
Nagar, I., Gupta, K., Batra, S., & Chauhan, D. (2025) · Neurodiversity · doi:10.1177/27546330251355813 · Cited by 1 · see citing works
Ali, D. A., Hale, E. W., Ascencio, A., & Berkowitz, S. J. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.08.002 · Cited by 1 · see citing works
Tabibi, Z., Ayoubi, S., & Rabbaniparsa, E. (2025) · Child Psychiatry & Human Development · doi:10.1007/s10578-025-01899-z · Cited by 1 · see citing works
Çankaya, P. K. (2025) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.1719949 · Cited by 1 · see citing works
Winogrodzki, I., Trzciński, B., Kowalczyk, P., Gugała, O., Stryczek-Schlusche, A., Furczyńska, A. M., Bracichowicz, F., Gęsińska, A., Paszkiewicz, H., & Nowak, K. (2025) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.3(47).2025.3606 · Cited by 1 · see citing works
Carr-Fanning, K., Lynam, A. M., Nicholson, T., & Mcguckin, C. (2025) · Brain Science · doi:10.3390/brainsci15101045 · Cited by 1 · see citing works
Maternal ADHD Diagnoses Before and After Childbirth: A Danish Population-Based Cohort Study
Madsen, K. B., Winther, M., Jensen, A. T., Marcussen, K., Munk‐Olsen, T., Wesselhoeft, R. T., & Kittel‐Schneider, S. (2025) · Journal of Attention Disorders · doi:10.1177/10870547251372730 · Cited by 1 · see citing works
“Late diagnosis is associated with diminished self-esteem, significant mental health challenges, disruptions in personal identity, and reduced life opportunities (Attoe & Climie, 2023; Skoglund et al., 2024; Young et al., 2020).”
Zhu, H. '., Kumar, A. S., Zhao, S., Wang, R., Tong, X., & Zhao, Y. (2025) · International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS) · doi:10.1145/3663547.3746387 · Cited by 1 · see citing works
“We identified a gap between prior work that qualitatively examined ADHD communities and that quantitatively evaluated ADHD video qualities via a medical lens on VSPs. Qualitative examination of ADHD communities on VSPs has focused on understanding community building and advocacy on VSPs, and didn’t…”
Zaritsky, R., Reed, S. C., & Evans, S. M. (2025) · Journal of Attention Disorders · doi:10.1177/10870547251400038 · Cited by 2 · see citing works
“Nonetheless, it is well-established that females with ADHD have significant impairment in various life domains, including career, home and family life, as well as social problems (Attoe & Climie, 2023; Cortese et al., 2016; Fedele et al., 2012; Young et al., 2020).”
Shim, J., Lee, S. I., Kim, S.-G., Ko, Y.-J., Youn, H., & Lee, J. (2026) · Psychiatry Investigation · doi:10.30773/pi.2025.0283 · Cited by 1 · see citing works
“14 Therefore, when evaluating adults who present with depression, anxiety, or interpersonal problems, clinicians should routinely assess for underlying ADHD, as appropriate diagnosis and treatment of ADHD can substantially improve both core symptoms and associated functional or emotional…”
Yeh, T., Hsu, C.-W., Tsai, S., Bai, Y., Su, T., Chen, T.-J., Liang, C., Chen, M., & Hsu, T. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121505 · Cited by 1 · see citing works
Alarachi, A., McNeely, H. E., Rowa, K., & McCabe, R. E. (2026) · British Journal of Clinical Psychology · doi:10.1111/bjc.70048 · Cited by 1 · see citing works
“One of these factors included identifying as a woman, which has been repeatedly cited in the literature as being associated with a missed diagnosis of ADHD (e.g., Attoe & Climie, 2023; Huynh et al., 2024).”
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Absence of funding for pharmacotherapy for adults with ADHD in Poland
Pankowski, D., & Wytrychiewicz‐Pankowska, K. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00110-x · Cited by 1 · see citing works
Binge, Purge, and Wander: Navigating Bulimia and Attention Deficit Hyperactivity Disorder (ADHD)
Jeremias, D., Santana, L., Braga, F., Mesquita, B., & Santos, C. P. (2024) · Cureus · doi:10.7759/cureus.69076 · Cited by 1 · see citing works
Not just a simple diagnosis of attention-deficit/hyperactivity disorder
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ADHD medications: a descriptive study of prescription trends in Tabriz, Iran, 2021-2022Preprint
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Epidemiology of Mental Health Conditions in Older Adult Women
Webb, F. J., Swagger, P., & Webster-Bass, S. (2024) · Springer eBooks · doi:10.1007/978-3-031-58293-6_4
Perspectives on Assessment Tools for Evaluating Students With ADHD During Career Transitioning
(2024) · Advances in higher education and professional development book series · doi:10.4018/979-8-3693-2635-0.ch007
郝, 丽. (2025) · Advances in Psychology · doi:10.12677/ap.2025.154255
The importance of gender and age for symptoms and epidemiology of ADHD
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- Authors
- Attoe, D. E., & Climie, E. A.
- Affiliations
- University of Calgary (CA)
- Corresponding author
- Climie, Emma A.
- Venue
- Journal of Attention Disorders
- Publisher
- SAGE Publications
- Published
- 2023-03-30
- Volume
- 27
- Issue
- 7
- Pages
- 645-657
- ISSN
- 1087-0547 (ISSN-L)
- 1557-1246
- PMC
- PMC10173330
- OpenAlex
- W4361270904
- Cited by
- 173
- References
- 38
- Citations by year
- 2026: 63 · 2025: 73 · 2024: 31 · 2023: 6
- FWCI
- 7.88
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Attention Disorders (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- adult ADHD, women, undiagnosed ADHD, delayed diagnosis, social and emotional wellbeing, interpersonal relationships, self-acceptance, lack of control, quality of life
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Emotions, Female, Humans
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