Time after Time – A Study about Girls and Women with ADHD

We are as happy as we are surprised by the great interest that our latest study has generated! We take it as a confirmation that it is about time that we focus on the mental health of girls and women with ADHD and establish a foundation for female precision health both within and outside healthcare.

The fact is that the male body historically has been the norm for everything from medical research to medicine and society. But the fact is also that women are more than just small men. Biological factors, such as sex hormones, affect the risk of both physical and mental health problems. Despite this, research and health care have almost exclusively focused on boys and men. And this skewed perception of the reality can have serious consequences for girls and women…

So, what is all the fuss about?

Well, in our latest study “Time after Time – Failure to identify and support females with ADHD” we looked at the age at which ADHD diagnoses are most often made and whether it differs between girls and boys, women, and men. It is a large population-based cross-sectional study based on data from over 2.4 million residents in the capital of Sweden (The Stockholm Region). The study was published in the Journal of Child Psychology and Psychiatry on December 3, 2023, and has already received a lot of attention both in the research world and in the media. In this study we followed and compare girls and boys, women, and men with ADHD based on health care utilization in primary and specialized inpatient hospital care, their somatic and psychiatric diagnoses, and the different medications they used five years before and after their ADHD diagnosis. We also included information about age, gender, migration, and cause of death. In total, over 85 thousand people participated between January 1, 2011, and December 21, 2021 and all individuals with ADHD were matched and compared with controls without ADHD.

The results, you wonder?

Well, we found that girls and women receive their ADHD diagnosis 4 years later than boys and men! The average age for receiving an ADHD diagnosis was 23.5 years in women compared to 19.6 years in men. Unfortunately, the result didn’t come as a huge surprise to us working with these issues. But it is, of course, serious since we know that a correct diagnosis is often a prerequisite for getting the right support and interventions. And delayed diagnoses, both in psychiatric and physical care, can have far-reaching consequences for health and quality of life. In the case of ADHD, it risks putting girls and women at a disadvantage that can, in the worst case, lead to lack of support and treatment.

We also saw that girls and women with ADHD had a lot of contacts and received a lot of different interventions within both psychiatric and physical care before receiving their ADHD diagnosis. In fact, much more compared to both boys and men with ADHD and girls and women without ADHD. They also used more medication than boys/men with ADHD and girls/women without a diagnosis and were overrepresented in everything from the use of sedatives and antidepressants to medication for insomnia and pain conditions. This high utilization of health care and pharmacological recourses was unfortunately not very surprising for us either, since we also saw that anxiety disorders were twice as common, and eating disorders ten times more common, in girls and women with ADHD compared to boys and men.

But why is this important?

Well, we argue that these findings are super important because we know that correct and timely diagnosis is absolutely crucial for how life with ADHD will develop. Therefore, we think that the results of this study should be interpreted as a clear call to us as a society that 1. girls and women with ADHD exist, 2. they struggle, and 3. their suffering can be passed on for generations if we do not do anything about it!

Who we are?

We are a research group led by Me, Helena Kopp Kallner and Lisa Thorell, very humbly calling ourselves The GODDESS ADHD Research Group (Gender-informed research to Overcome Diagnostic Delay and Emotional dysregulation through Self-awareness and Self-efficacy in female ADHD). Our team consists of researchers and clinicians from child and adolescent psychiatry, adult psychiatry, addiction medicine, gynecology and obstetrics, epidemiology, developmental psychology, sociology, and social sciences. By gathering experts from so many different areas in society and by collaborating closely with girls and women living with ADHD, we hope to contribute to more research and new smart tools that can improve both healthcare and self-care for girls and women with ADHD. We believe that reducing the time from when a girl shows symptoms until she receives her diagnosis is crucial for reducing the high use of medication and the development of comorbidity that we see in girls and women with ADHD. We believe that knowledge and self-awareness are the most important weapons in the battle to improve physical, mental, and sexual health in girls and women with ADHD.

Read our Time after Time study here:

Time after time: failure to identify and support females with ADHD – a Swedish population register study – Skoglund – Journal of Child Psychology and Psychiatry – Wiley Online Library

/Lotta Borg Skoglund