Interestingly, ADHD symptoms are usually different in girls and boys during childhood. Girls show less hyperactivity and this may lead to later identification and later treatment. Could this affect the development of other psychiatric disorders in adulthood? This was the big question behind a study examining differences in mental health among men and women with ADHD.
Previous studies have tried to figure out differences among men and women with ADHD in the risk of psychiatric comorbidities. Our study is the first to actually show such differences.
In our study, we linked information from four large national registries in Norway, and identified 40,000 adults with ADHD, which is 2.4% of the adult population. We compared them with the remaining population of 1.6 million Norwegian adult inhabitants without ADHD. The psychiatric disorders we studied were anxiety, bipolar, depression, personality disorder, schizophrenia spectrum (schizophrenia) and substance use disorders (SUD).
Both men and women with ADHD were 4-9 more likely to be diagnosed with these psychiatric disorders compared with the remaining population. We also found that there were significant differences in risk of a psychiatric diagnosis between men and women with ADHD.
Women with ADHD were significantly more often diagnosed with anxiety, depression, bipolar and personality disorder than men, while men with ADHD had more schizophrenia and SUD.
We also found that a considerable proportion of anxiety, bipolar disorder, depression, schizophrenia, SUD and personality disorders in the population could be explained by an underlying ADHD. About 6 percent of depression and 13 percent of bipolar disorders in women could be related to ADHD.
What clinicians need to know is that when treating adults with ADHD, they should be aware of these gender-specific psychiatric comorbidities, in order to both detect the conditions and offer early treatment if diagnosed. Importantly, clinicians should also be aware of a possible underlying ADHD when adults present with symptoms of other psychiatric disorders.
It is also important to identify children and adolescents with ADHD at earlier stages in order to reduce the risk of future psychiatric comorbidity. This may be particularly important in girls and women with ADHD, who often have a lower degree of hyperactivity and are therefore at an increased risk of being undiagnosed in childhood. This could result in a higher risk of developing other psychiatric disorders as a possible consequence as they grow older.
This study was done at Stiftelsen Kristian Gerhard Jebsen Center for research on Neuropsychiatric disorders, University of Bergen, Norway, and published OnlineOpen in Acta Psychiatrica Scandinavica, December 2017, with the title: “Gender Differences in Psychiatric Comorbidity: A Population-based Study of 40,000 Adults with Attention-Deficit Hyperactivity Disorder”