Sex Differences in Diagnosis and Treatment Timing of Comorbid Depression/Anxiety and Disease Subtypes in Patients With ADHD: A Database Study

J Atten Disord. 2024 Aug;28(10):1347-1356. doi: 10.1177/10870547241251738. Epub 2024 May 16.

Abstract

Objective: Our study examined the impact of sex, ADHD subtype, and comorbid illnesses (depression/anxiety) on the timing of diagnosis and treatment for ADHD.

Method: To analyze ADHD patients, four health databases were used to assess subtype, comorbid mood, and antidepressant or anxiolytic drug exposure. Analyses were stratified by sex and age. Standardized mean differences measured intergroup differences.

Results: Females with ADHD were identified at older ages and had higher rates of depression and anxiety diagnoses and treatments before and after their initial ADHD diagnosis. Predominantly inattentive ADHD patients were diagnosed later and more likely to receive mood disorder diagnosis and treatment than hyperactive impulsive ADHD patients.

Conclusions: Results suggest a more complex ADHD presentation in females, potentially causing late diagnosis and delayed treatment.

Keywords: anxiety; attention deficit disorder with hyperactivity; depression; female; gender differences; humans; male; real world data; real world evidence; sex factors.

MeSH terms

  • Adolescent
  • Adult
  • Antidepressive Agents / therapeutic use
  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Attention Deficit Disorder with Hyperactivity* / diagnosis
  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Attention Deficit Disorder with Hyperactivity* / psychology
  • Child
  • Comorbidity*
  • Databases, Factual
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / psychology
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Female
  • Humans
  • Male
  • Sex Factors
  • Young Adult

Substances

  • Antidepressive Agents