The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
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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“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]
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“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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Cites
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“Using techniques of thematic analysis (Braun & Clarke, 2006), eight articles were reviewed.”
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Tucker‐Retter, E. K., & Westermeyer, H. D. (2025) · Veterinary Ophthalmology · doi:10.1111/vop.70030
“It has only recently become apparent that ADHD not only persists into adulthood and is a life-long disorder, but that people with ADHD may reach adulthood without being diagnosed as children [37].”
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Tingate, R., Fullam, R. S., & Nixon, M. (2025) · Victims & Offenders · doi:10.1080/15564886.2025.2525278
“Data regarding prevalence is likely to be limited by poor access to diagnosis and gendered differences in presentation and recognition of disability (Attoe & Climie, 2023; Levine et al., 2018; Spivakovsky, 2021).”
Art Therapy and ABR: Exploring ADHD Roles in a Neurodivergent Case Study
Fried, D. (2025) · Art Therapy · doi:10.1080/07421656.2025.2518778
The Experience of Reintegration from Prison for Women with Cognitive Disabilities
Tingate, R., Fullam, R. S., & Nixon, M. (2025) · Women & Criminal Justice · doi:10.1080/08974454.2025.2566003
Wu, Y., Chua, K., McManus, S., Morgan, Z., & Oram, S. (2025) · medRxiv · doi:10.1101/2025.10.08.25337602
“For instance, women with ADHD may be more likely to experience trauma, emotional dysregulation, or relationship conflict, factors which increase the risk of both IPV perpetration and victimisation (Attoe & Climie, 2023).”
FOR: Adult ADHD is a valid condition requiring “clinical attention”!
Srivastava, C. (2025) · Journal of Indian Association for Child and Adolescent Mental Health · doi:10.1177/09731342251380377
Fakhari, A., Farahbakhsh, M., Azimian, A., Khameneh, A., Matinkia, M., & Aghajani, E. (2025) · Research Square · doi:10.21203/rs.3.rs-7468341/v1
Schippers, L. M., Hoogman, M., & Greven, C. U. (2025) · Current Research in Behavioral Sciences · doi:10.1016/j.crbeha.2025.100193
Hulsey, B., & Walker, C. (2025) · JAAPA · doi:10.1097/01.jaa.0000000000000286
Leppänen, M. H., Vuori, M. A., Pape, B., Kaittila, A., Kraav, S., Tolmunen, T., Anis, M., Karukivi, M., & Rautava, P. (2025) · JCPP Advances · doi:10.1002/jcv2.70067 · Cited by 1
“ADHDin girlsshouldberecognizedatanearlystage,asfemaleswithADHDmay experiencemorepsychological,psychiatric,andcognitivedistressthan boys with ADHD later in life (Attoe & Climie, 2023; De Ronda et al., 2023; Skoglund et al., 2023).”
Schools Responding to the Special Needs of Girls
Ladegard, K. M., Ryst, E., Shah, K., & Wimbiscus, M. M. (2025) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2025.08.003
Goh, P. K., Chung, S., Jhawar, N., Wong, A. W. W. A., Mellor, G. S., Banerjee, M., & Hartung, C. M. (2025) · Journal of Attention Disorders · doi:10.1177/10870547251389337
“…detect), biases toward the male presentation of ADHD in clinical practice and disorder conceptualization (leading to ADHD in girls being overlooked by typical referral sources like parents, teachers, and pediatricians), and gender-based societal norms and values (reviewed in Attoe & Climie, 2023).”
Witteveen, K., & O’Hara, D. (2025) · International Journal for the Advancement of Counselling · doi:10.1007/s10447-025-09620-4
“Of particular note is the gap in the literature pertaining to the experiences of women (Attoe & Climie, 2023; Hinshaw et al., 2022), despite evidence to suggest women with ADHD remain more likely than men to be diagnosed later in life (da Silva et al., 2020) and are at elevated risk of several…”
Ryu, S., Kim, S., Lee, D.-E., Jeong, E., Lee, S. H., & Seo, J. (2025) · International Journal of Qualitative Methods · doi:10.1177/16094069251404346 · Cited by 1
“Role expectations imposed on women and mothers can deepen functional impairment and anxiety and lower self-ef fi cacy (Attoe & Climie, 2023), and amid social norms and role expectations, women with ADHD tend to respond with masking, camou fl aging, and a certain level of compensatory strategies…”
Was it ADHD I had all along? Perceived consequences for women diagnosed with ADHD in adulthood
Qvale, L. M., & Piech, R. M. (2025) · Nordic Psychology · doi:10.1080/19012276.2025.2601535 · Cited by 1
Atomoxetine as a Viable ADHD Treatment in Breastfeeding Mothers
Yamada, E. M., Trehan, S., Stark, A., Krutsch, K., & Datta, P. (2025) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000002109
van der Plas, N. E., Kaag, A. M., Franke, B., Hartman, C. A., Hoekstra, P. J., Rommelse, N. N. J., Sprooten, E., Oosterlaan, J., Luman, M., & Noordermeer, S. D. S. (2026) · Neurodiversity · doi:10.1177/27546330261480183
Mehmedović, A., & Kostic, M. V. (2025) · Medicinska rec · doi:10.5937/medrec2502089m
Hu, E. H., Faraone, S. V., & Morgan, P. L. (2026) · Journal of Attention Disorders · doi:10.1177/10870547251415574
Varbanov, V., & Overton, P. G. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1754032
Teverovsky, E., Leffa, D. T., Wang, Y., Jacobsen, E. P., Chang, C. H., Kamboh, M. I., Molina, B. S. G., & Ganguli, M. (2026) · International Psychogeriatrics · doi:10.1016/j.inpsyc.2026.100201
Support without identification: a regressive shift in neurodevelopmental care?
Lang, J., Rutherford, M., Gajwani, R., Shaw, S. C. K., Doherty, M., & Minnis, H. (2026) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(26)00037-4
Women’s and girls’ ADHD diagnosis journeys: a mother-daughter autoethnography
Wheaton, B., & Holland, P. (2026) · Medical Humanities · doi:10.1136/medhum-2025-013423
Screen time, social jetlag, future hope, and ADHD symptoms in university students
Kurtaran, N. E., Uysal, B., & Öztürk, L. (2026) · Chronobiology International · doi:10.1080/07420528.2026.2642792
“While literature suggests that females may internalize symptoms (e.g. anxiety) more than males (Attoe and Climie 2023; Duo et al. 2025), in our unified regression model, gender was not a significant predictor.”
Not just boys: The overlooked story of ADHD in women and girls
Climie, E. A., & Callahan, B. L. (2026) · doi:10.64628/aam.7pewrmdce
Diagnosis and Management of Adult Attention-Deficit/Hyperactivity Disorder
Worringer, E., & Caçoilo, M. (2026) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2026.01.006
The Undiagnosed: Ending the Lost Generation of Girls With ADHD
Perkins, S., & Trombley, A. (2026) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2026.105784
Mental Health and Coping in Women With ADHD During the Pandemic
Nurgitz, R., & Miller, C. J. (2026) · Journal of Attention Disorders · doi:10.1177/10870547261437893
“Due to concerns about underdiagnosis of females (Attoe & Climie, 2023; Hinshaw et al., 2022) and limited access to publicly funded psychological assessments in Canada, self-reported inattention symptoms typically associated with ADHD were used to assign membership two groups: low risk for ADHD and…”
InfluentialBasu, A., Dooley, P., & Casper, G. R. (2026) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-80686-693-920261007
Main challenges to diagnosing ADHD in females – A narrative review
Risa, M., Selvikvaag, M. E. H., Gorecka, M. M., Sonuga-Barke, E. J. S., & Raudeberg, R. (2026) · Tidsskrift for Norsk psykologforening · doi:10.52734/mfpf9538
Sentrale utfordringer i diagnostikk av ADHD hos kvinner – En narrativ litteraturgjennomgang
Risa, M., Selvikvaag, M. E. H., Gorecka, M. M., Sonuga-Barke, E. J. S., & Raudeberg, R. (2026) · Tidsskrift for Norsk psykologforening · doi:10.52734/lyek9887
Gajda, K., & Swebodziński, B. (2026) · Research Square · doi:10.21203/rs.3.rs-9257351/v1
Effects of ADHD on additional language learning and use
Kałdonek‐Crnjaković, A. (2026) · Studies in Second Language Acquisition · doi:10.1017/s0272263126101533
“In contrast, recent studies have explored adult populations (e.g., see Prakash et al., 2021) and sex-related variations of symptoms (e.g., Attoe & Climie, 2023; Young et al., 2020).”
Yılancıoğlu, H. Y., Bildik, T., Pırıldar, Ş., Yüncü, Z., Kırlı, U., Pilan, B. Ş., Yektaş, Ç., Tatar, A., Inal-Kaleli, I., & Doğan, N. (2026) · Neuropsychobiology · doi:10.1159/000552126
“Indeed, ADHD in girls may often go unrecognized due to less overt externalizing symptoms, overlap with internalizing symptomatology, and delays in help-seeking behaviours [41, 42].”
Gibbs, K., & Bialocerkowski, A. (2026) · Disability and Rehabilitation · doi:10.1080/09638288.2026.2676064
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Under the Neurodivergent Umbrella: A Qualitative Exploration of Neurodivergence and Remote Work
Kuhn, L., & Meier, F. J. (2026) · Lecture notes in information systems and organisation · doi:10.1007/978-3-032-08483-5_19
A Systematic Review of Lived Experiences of Receiving a Diagnosis of ADHD in Adulthood
McGill, L., Jardim-Lalor, I., & O’Connor, C. (2026) · Journal of Attention Disorders · doi:10.1177/10870547261455946 · Cited by 1
“While certain findings echo those identified in previous syntheses, affirming the consistency of these trends (Attoe & Climie, 2023; Bjerrum et al., 2017; Ginapp et al., 2022; Long & Coats, 2022), the expanded evidence-base considered in this review adds nuance and extends insights regarding…”
InfluentialStrategic Investment in ADHD Support: Insights from Canadian Educational and Coaching Professionals
Miller, C. J., Bedard, A., Climie, E. A., Corkum, P. V., Espinet, S. D., Grizenko, N., Jiang, Y., Rogers, M., Toplak, M. E., & Callahan, B. L. (2026) · School Mental Health · doi:10.1007/s12310-026-09882-2
“…ADHD often present with a preponderance of attention difficulties and are less likely to be described as hyperactive or behaviourally impulsive (Attoe & Climie, 2023; Hinshaw et al., 2022 ), which may reduce the likeli - hood of a girl or woman being diagnosed or receiving…”
Alderson, E., Bowden, N., McLay, L., Beaglehole, B., & Schlüter, P. J. (2026) · JCPP Advances · doi:10.1002/jcv2.70133
“Without timely support, these internalised symptoms may lead females to experience low self - esteem, sense of powerlessness, heightened emotional dysregulation, difficulties maintaining relationships, and self - destructive behaviors (Attoe & Climie, 2023; Young et al., 2020).”
Seery, C., Leonard-Curtin, A., Fennessy, J., Rudden, H., McLaughlin, D., Dio, F. U., Cassidy, S., Kilbride, K., Wrigley, M., & Bramham, J. (2026) · Research in Neurodiversity · doi:10.1016/j.rin.2026.100042
SEX DIFFERENCES IN ADHD – DIAGNOSTIC AND THERAPEUTIC CHALLENGES
Marek, A., Balińska, W., Rogowska, J., & Wąsik, J. (2026) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.1(49).2026.4605
Gibbs, K., Wheeley, E., Devi, A., & Main, K. (2026) · SN Social Sciences · doi:10.1007/s43545-026-01527-0
“Given the interrelatedness between lower self-efficacy and self-esteem in women and girls not diagnosed (Attoe and Climie 2023) alongside information shared by the participants in our study, it could be that both their cognitive capabilities and socialisation as women meant that the academic…”
Winther, M., Maimburg, R. D., Kittel-Schneider, S., Bøttcher, L., & Madsen, K. B. (2026) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-026-03168-3
Psychiatric difficulties in females with fragile X syndrome: a systematic review and meta-analyses
Jenner, L., Koenig, C., Hantman, R. M., Hogan, A. L., Roberts, J. E., & Klusek, J. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1886787
Unmasking the Mystery: ADHD, Women, and Hormones
Galgani, C. J. L. (2026) · Clinical Journal for Nurse Practitioners in Women s Health · doi:10.1891/cjnpwh-2025-0052
Haavisto, R., Rasanen, V., Jallow, J., Riipinen, P. K., Riala, K., Hakko, H. H., Säynäjäkangas, V., & Halt, A. (2026) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2026.2700405
“Women tend to exhibit predominantly inattentive symptoms rather than hyperactive ones, which are often more subtle and, consequently, less likely to lead to a diagnostic referral [3].”
InfluentialEdmondson, M. E., & Ridgel, A. L. (2026) · Western Journal of Nursing Research · doi:10.1177/01939459261458869
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Sepúlveda-Morales, R. (2026) · Actualización en Medicina de Familia · doi:10.55783/amf.cimf220703
Ouderen met autisme en/of ADHD
Wijnbelt, C., van Gestel, L., & Videler, A. (2026) · doi:10.1007/978-90-368-3222-9_14
Vodička, M. (2026) · Psychiatrie pro praxi · doi:10.36290/psy.2026.014
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Ryu, S., Kim, S., Zylowska, L., & Seo, J. Y. (2026) · Journal of Attention Disorders · doi:10.1177/10870547261468155
Kelly, T., May, B., Porter, C. N., & Palace, M. (2026) · Journal of Attention Disorders · doi:10.1177/10870547261469625
Jóźwiak, J. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27156748
“This four-dimensional model may further help explain why many individuals with predominantly inattentive presentations remain unrecognized for years, with substantial negative consequences [10,83,84].”
Sex Differences in Adult ADHD: A Multidimensional Multi-Informant Observational Study
Magnesa, A., Costagli, E., Dominicis, F. D., Rosa, U. D., Iriti, A., Petrucci, A., Rimoldi, B., Medda, P., Schiavi, E., Brancati, G. E., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15155954
Pleshkevich, M., Broomfield, R. R., Burton, S., Castro, G., Gill, A. G., Jerram, M. W., & Parsa, S. (2026) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acag057
Tak hanya laki-laki, perempuan juga bisa mengalami ADHD dan sering diabaikan
Climie, E. A., & Callahan, B. L. (2026) · doi:10.64628/aan.74rmdt3qg
Gender Bias and Misdiagnosis of ADHD in Women and Girls
Schellekens, M., & Chrisostomou, L. (2026) · Springer eBooks · doi:10.1007/978-3-030-12852-4_109-1
Penning, L., Daseking, M., & Koerner, J. K. A. (2026) · Child Psychiatry & Human Development · doi:10.1007/s10578-026-02074-8
Early maladaptive schemas and attention-deficit/hyperactivity disorder: a scoping review
Cook, M., & Allen, A. (2026) · Clinical Psychologist · doi:10.1080/13284207.2026.2713449
Dunn, V. S., Hodgson, P., & Petty, S. (2026) · Research in Neurodiversity · doi:10.1016/j.rin.2026.100062
Comprehensive Assessment of ADHD Across the Lifespan
Llerena, K., & Melland, A. (2026) · Springer eBooks · doi:10.1007/978-3-032-24171-9_3
Sex Bias in the Clinical Diagnosis of ADHD: A Critical Review
Salehpour, F., & Gonzalez-Lima, F. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15176804
Williams, T., Jones, R. B., Livingston, L. A., Agha, S. S., Barclay, I., Ford, T. J., John, A., Sayal, K. S., Thapar, A., & Martin, J. (2026) · Neurodiversity · doi:10.1177/27546330261487214
Cuomo, A., Pinzi, M., & Fagiolini, A. M. (2026) · Brain Sciences · doi:10.3390/brainsci16090965
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InfluentialTomaszewska, A. J., Kaczmarek, M., Pojawa, M., Chudzik, A., Prządka, J., Buzek, E., & Witkowska, W. (2026) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.3(51).2026.5946
“Studies show that women with undiagnosed ADHD often experience prolonged psychological distress, reduced self-esteem, impaired occupational functioning, and difficulties in interpersonal relationships (Attoe & Climie, 2023; Holden & Kobayashi-Wood, 2025).”
Wong, A., Rempel, D., Katz, L. Y., Dhankar, A., & Leong, C. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-123164
Public health aspects of adult attention-deficit hyperactivity disorder
Udo, I. I., Gabriels, P., & Orewa, H. (2026) · BJPsych Advances · doi:10.1192/bja.2026.10228
Neurodivergence et dynamique familiale : une perspective systémique
Amdjadi, N. A. (2026) · Cahiers critiques de thérapie familiale et de pratiques de réseaux · doi:10.3917/ctf.077.0087
ADHD in the Age of Neurodiversity: AI-Enabled Support, Integrating Diagnosis, Stigma and Strengths
Gopal, J., Shah, U., & Patel, B. (2026) · IntechOpen eBooks · doi:10.5772/intechopen.1018210
Exploring Late-Onset ADHD in Women: A Data-Driven Approach Using AI and Socio-Demographic Analysis
Myneni, S. (2026) · Critical Debates in Humanities Science and Global Justice · doi:10.68709/001c.160095
Metadata
- 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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