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Antecedents and outcomes of a later attention–deficit hyperactivity disorder (ADHD) diagnosis in females
,
Olivier Y. Rouquette,
Kate Langley,
Miriam Cooper,
Kapil Sayal ,
Tamsin J. Ford ,
Ann John ,
Anita Thapar
The British Journal of Psychiatry, Pages: 1 - 8
Swansea University Author:
Ann John
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© The Author(s), 2026. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence.
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DOI (Published version): 10.1192/bjp.2026.10556
Abstract
Background: Females are less likely than males to be diagnosed with attention–deficit hyperactivity disorder (ADHD). When diagnosed, females are older than males. AimsIn this study, we examined the childhood antecedents of later ADHD diagnosis and its impact on adolescent/emerging adult outcomes, wi...
| Published in: | The British Journal of Psychiatry |
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| ISSN: | 0007-1250 1472-1465 |
| Published: |
Royal College of Psychiatrists
2026
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa71276 |
| Abstract: |
Background: Females are less likely than males to be diagnosed with attention–deficit hyperactivity disorder (ADHD). When diagnosed, females are older than males. AimsIn this study, we examined the childhood antecedents of later ADHD diagnosis and its impact on adolescent/emerging adult outcomes, with a focus on females.Method: In this cohort study, we used data from a Welsh nation-wide electronic cohort of 13 593 individuals (n = 2680 (19.7%) females) diagnosed with ADHD and 578 793 individuals (n = 286 734 (49.5%) females) without ADHD. We compared females with later diagnoses (ages 12–25) to those with earlier, timely diagnoses (ages 5–11) and no diagnosis, in terms of childhood (ages 5–11) antecedents and adolescent/adult (ages 12–25) outcomes. We also tested for sex differences. Results: Although females with earlier ADHD diagnosis showed more health and educational difficulties in childhood than those with later diagnosed ADHD (odds ratios ranged from 0.18 to 0.92), there was clear evidence of these difficulties in females with later diagnosed ADHD, compared with females without ADHD (odds ratios: 1.07–9.02). In adolescence/early adulthood, females with later diagnosed ADHD used more healthcare services and had worse mental health, educational and socioeconomic outcomes than females diagnosed earlier (odds ratios: 1.39–4.96) and those without ADHD (odds ratios: 1.54–23.98). Many of these outcomes were exacerbated in females compared with males. Conclusions: The results demonstrate that later ADHD diagnosis is associated with significant negative outcomes by adolescence and disproportionately disadvantages females. Despite later diagnosis, there was clear evidence of childhood mental health and educational difficulties when compared with females without ADHD. Therefore, timely childhood ADHD diagnosis may help to mitigate later risks, especially for females. |
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| Keywords: |
Attention–deficit hyperactivity disorder; neurodevelopmental disorders; mental health services; electronic health records; child and adolescent psychiatry |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This study was funded by the Welsh Government through Health and Care Research Wales via a National Institute for Health and Care Research (NIHR) Advanced Fellowship (Ref: NIHR-FS(A)-2022) and was also supported by a NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation (grant no. 27879). |
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