Article Impact Level: HIGH Data Quality: STRONG Summary of European College of Neuropsychopharmacology https://doi.org/10.1192/j.eurpsy.2025.2441 Dr. Ferran Mestres et al.
Points
- This population-based study of 900 adults with ADHD found that females are diagnosed significantly later than males, emphasizing the need for improved diagnostic protocols across healthcare systems.
- Females exhibited greater ADHD severity (p<0.001) and significantly higher rates of depression (p=0.003) and anxiety (p<0.001), compared to males, highlighting distinct comorbidity patterns.
- The study showed females reported poorer functioning (p=0.039) and greater disability (p=0.001) than males, though their rates of substance use were notably lower (p<0.001).
- The combined ADHD subtype was independently associated with the highest clinical severity, increased impulsive symptoms, and greater levels of anxiety, depression, and substance use.
- A significant statistical interaction effect between sex and subtype was observed only for disability, suggesting that females with the combined subtype experience the most severe functional impairment.
Summary
This population-based study investigated sex differences in Attention-Deficit/Hyperactivity Disorder (ADHD) presentation, psychiatric comorbidities, and functional impairment among 900 diagnosed adults. Utilizing validated assessment tools and applying bivariate analyses and General Linear Models (GLMs), researchers examined sex- and subtype-specific effects and their interactions. The findings indicated that while there were no significant sex differences in ADHD subtype distribution or age of symptom onset, females were diagnosed with ADHD significantly later than males (p<0.001), supporting previous literature on delayed diagnosis in females.
In comparisons of clinical severity and comorbidities, females with ADHD exhibited greater overall ADHD severity (p<0.001), higher levels of depression (p=0.003) and anxiety (p<0.001), but significantly lower substance use (p<0.001) compared to males. Furthermore, females demonstrated poorer functioning (p=0.039) and greater disability (p=0.001) than their male counterparts. Hazard ratios and confidence intervals were not reported in this abstract but are essential for quantifying risk and statistical precision in the full paper.
The combined ADHD subtype was independently associated with the highest clinical severity, greater symptoms of depression, anxiety, and impulsivity, and increased substance use and disability. Critically, a significant interaction between sex and subtype was identified only for disability. Females in the combined subtype group exhibited the most pronounced functional impairment, emphasizing the need for diagnostic and treatment protocols to independently account for the interplay of sex and ADHD subtype to optimize patient outcomes.
References
Mestres, F., Richarte, V., Crespín, J. J., Torrent, C., Biel, S., Ramos, C., Ibáñez, P., Oltra-Arañó, L., Corrales, M., Amoretti, S., Fadeuilhe, C., & Ramos-Quiroga, J. A. (2025). Sex differences in adults with attention-deficit/hyperactivity disorder: A population-based study. European Psychiatry, 68(1), e90. https://doi.org/10.1192/j.eurpsy.2025.2441
