{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:18:00Z","timestamp":1788499080841,"version":"build-2803163510"},"reference-count":83,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Oskar Fischer Project","award":["201703074001FP"],"award-info":[{"award-number":["201703074001FP"]}]},{"DOI":"10.13039\/100032958","name":"Elhapa Foundation","doi-asserted-by":"crossref","award":["201904006001FP"],"award-info":[{"award-number":["201904006001FP"]}],"id":[{"id":"10.13039\/100032958","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Attention-deficit\/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that manifests differently across sexes, potentially impacting symptomatology, diagnosis, and treatment. Nevertheless, these legitimate sex differences in ADHD are further shaped by multiple sources of bias that distort prevalence estimates and clinical recognition. Methods: This critical review synthesizes evidence on a variety of factors, including sampling bias, referral bias, DSM criteria, and diagnostic overshadowing, that may contribute to the under-recognition and misdiagnosis of ADHD in females. Results: Studies suggest that sampling and referral biases inflate male representation by overemphasizing disruptive behaviors and underrecognizing inattentive presentations in females. Item-level symptom endorsement differences indicate that several DSM-5 criteria map more closely onto male-typical behaviors, reducing sensitivity to female-specific manifestations. Diagnostic thresholds, age-of-onset, and pervasiveness criteria further disadvantage females, whose symptoms are often less overt or more context-dependent. Recognition bias and diagnostic overshadowing by mood and anxiety disorders contribute to missed or delayed diagnoses. Conclusions: Together, these findings highlight that observed sex differences in ADHD reflect not only true psychobiological variation but also systematic biases in assessment and diagnosis, underscoring the need for more sex-sensitive diagnostic frameworks and improved clinical awareness. The extent of these diagnostic disparities may also vary across cultural contexts and healthcare systems, including differences in symptom perception, referral pathways, and access to specialist assessment.<\/jats:p>","DOI":"10.3390\/jcm15176804","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:56:01Z","timestamp":1788339361000},"page":"6804","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex Bias in the Clinical Diagnosis of ADHD: A Critical Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7070-8835","authenticated-orcid":false,"given":"Farzad","family":"Salehpour","sequence":"first","affiliation":[{"name":"Department of Psychology, Texas Consortium in Behavioral Neuroscience, The University of Texas at Austin, Austin, TX 78712, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9856-0775","authenticated-orcid":false,"given":"Francisco","family":"Gonzalez-Lima","sequence":"additional","affiliation":[{"name":"Department of Psychology, Texas Consortium in Behavioral Neuroscience, The University of Texas at Austin, Austin, TX 78712, USA"},{"name":"Interdisciplinary Neuroscience Program, Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15020","DOI":"10.1038\/nrdp.2015.20","article-title":"Attention-deficit\/hyperactivity disorder","volume":"6","author":"Faraone","year":"2015","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1007\/s13311-012-0135-8","article-title":"The prevalence of DSM-IV attention-deficit\/hyperactivity disorder: A meta-analytic review","volume":"9","author":"Willcutt","year":"2012","journal-title":"Neurotherapeutics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1007\/s00787-018-1211-3","article-title":"Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment","volume":"28","author":"Mowlem","year":"2019","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1002\/jnr.25038","article-title":"Clinical characteristics, neuroimaging findings, and neuropsychological functioning in attention-deficit hyperactivity disorder: Sex differences","volume":"101","author":"Carucci","year":"2023","journal-title":"J. Neurosci. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.cpr.2015.05.005","article-title":"Gender differences in adults with attention-deficit\/hyperactivity disorder: A narrative review","volume":"40","author":"Williamson","year":"2015","journal-title":"Clin. Psychol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/S2215-0366(24)00010-5","article-title":"Why are females less likely to be diagnosed with ADHD in childhood than males?","volume":"11","author":"Martin","year":"2024","journal-title":"Lancet Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1177\/1087054711416909","article-title":"ADHD and female specific concerns: A review of the literature and clinical implications","volume":"16","author":"Nussbaum","year":"2012","journal-title":"J. Atten. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1080\/21622965.2018.1430576","article-title":"Overdiagnosis of ADHD in boys: Stereotype impact on neuropsychological assessment","volume":"8","author":"Fresson","year":"2019","journal-title":"Appl. Neuropsychol. Child"},{"key":"ref_9","first-page":"27250","article-title":"A review of attention-deficit\/hyperactivity disorder in women and girls: Uncovering this hidden diagnosis","volume":"16","author":"Quinn","year":"2014","journal-title":"Prim. Care Companion CNS Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s10862-024-10188-3","article-title":"A call to analyze sex, gender, and sexual orientation in psychopathology research: An illustration with ADHD and internalizing symptoms in emerging adults","volume":"47","author":"Hartung","year":"2025","journal-title":"J. Psychopathol. Behav. Assess."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1111\/jcpp.13480","article-title":"Annual Research Review: Attention-deficit\/hyperactivity disorder in girls and women: Underrepresentation, longitudinal processes, and key directions","volume":"63","author":"Hinshaw","year":"2022","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1210\/endrev\/bnaa034","article-title":"Considering sex as a biological variable in basic and clinical studies: An endocrine society scientific statement","volume":"42","author":"Bhargava","year":"2021","journal-title":"Endocr. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1038\/s41582-023-00774-6","article-title":"Sex and gender in neurodevelopmental conditions","volume":"19","author":"Neufeld","year":"2023","journal-title":"Nat. Rev. Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1176\/ajp.151.11.1673","article-title":"DSM-IV field trials for attention deficit hyperactivity disorder in children and adolescents","volume":"151","author":"Lahey","year":"1994","journal-title":"Am. J. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1176\/appi.ajp.2012.12070998","article-title":"DSM-5 field trials in the United States and Canada, part I: Study design, sampling strategy, implementation, and analytic approaches","volume":"170","author":"Clarke","year":"2013","journal-title":"Am. J. Psychiatry"},{"key":"ref_16","first-page":"1","article-title":"Improving clinical diagnosis using the executive functioning\u2014Self-regulation theory of ADHD","volume":"30","author":"Barkley","year":"2022","journal-title":"ADHD Rep."},{"key":"ref_17","first-page":"217","article-title":"Sex and age differences in attention-deficit\/hyperactivity disorder symptoms and diagnoses: Implications for DSM-V and ICD-11","volume":"49","author":"Ramtekkar","year":"2010","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1192\/bjp.bp.107.048827","article-title":"Prevalence and correlates of adult attention-deficit hyperactivity disorder: Meta-analysis","volume":"194","author":"Simon","year":"2009","journal-title":"Br. J. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/10634266040120040501","article-title":"Effects of child gender and symptom type on referrals for ADHD by elementary school teachers","volume":"12","author":"Sciutto","year":"2004","journal-title":"J. Emot. Behav. Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1097\/00004583-199908000-00012","article-title":"Clinical correlates of ADHD in females: Findings from a large group of girls ascertained from pediatric and psychiatric referral sources","volume":"38","author":"Biederman","year":"1999","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1177\/108705470200500302","article-title":"A meta-analytic review of gender differences in ADHD","volume":"5","author":"Gershon","year":"2002","journal-title":"J. Atten. Disord."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1097\/00004583-199708000-00011","article-title":"Gender differences in ADHD: A meta-analysis and critical review","volume":"36","author":"Gaub","year":"1997","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s10802-018-0434-6","article-title":"Invariance of ADHD symptoms across sex and age: A latent analysis of ADHD and impairment ratings from early childhood into adolescence","volume":"47","author":"Leopold","year":"2019","journal-title":"J. Abnorm. Child Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.paid.2006.08.011","article-title":"Testing gender differential item functioning for ordinal and binary scored parent rated ADHD symptoms","volume":"42","author":"Gomez","year":"2007","journal-title":"Personal. Individ. Differ."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Platania, N.M., Starreveld, D.E., Wynchank, D., Beekman, A.T., and Kooij, S. (2025). Bias by gender: Exploring gender-based differences in the endorsement of ADHD symptoms and impairment among adult patients. Front. Glob. Women\u2019s Health, 6.","DOI":"10.3389\/fgwh.2025.1549028"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"106064","DOI":"10.1016\/j.neubiorev.2025.106064","article-title":"An item-level systematic review of the presentation of ADHD in females","volume":"171","author":"Williams","year":"2025","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s10578-005-2694-y","article-title":"Gender appropriateness of symptom criteria for attention-deficit\/hyperactivity disorder, oppositional-defiant disorder, and conduct disorder","volume":"35","author":"Ohan","year":"2005","journal-title":"Child Psychiatry Hum. Dev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1007\/s10802-020-00618-7","article-title":"ADHD parent and teacher symptom ratings: Differential item functioning across gender, age, race, and ethnicity","volume":"48","author":"DuPaul","year":"2020","journal-title":"J. Abnorm. Child Psychol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"103205","DOI":"10.1016\/j.ajp.2022.103205","article-title":"Gender-based differences in prevalence and effects of ADHD in adults: A systematic review","volume":"75","author":"Faheem","year":"2022","journal-title":"Asian J. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1007\/BF01670100","article-title":"Sex differences in ADHD: Conference summary","volume":"24","author":"Arnold","year":"1996","journal-title":"J. Abnorm. Child Psychol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"i-130","DOI":"10.2307\/1166156","article-title":"National survey of problems and competencies among four-to sixteen-year-olds: Parents\u2019 reports for normative and clinical samples","volume":"56","author":"Achenbach","year":"1991","journal-title":"Monogr. Soc. Res. Child Dev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/BF00960783","article-title":"Are girls with problems of attention underrecognized?","volume":"13","author":"McGee","year":"1991","journal-title":"J. Psychopathol. Behav. Assess."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"DuPaul, G.J., Power, T.J., Anastopoulos, A.D., and Reid, R. (2016). ADHD Rating Scale? 5 for Children and Adolescents: Checklists, Norms, and Clinical Interpretation, Guilford Publications.","DOI":"10.1037\/t05638-000"},{"key":"ref_34","unstructured":"Barkley, R.A. (2011). Barkley Adult ADHD Rating Scale-iv (BAARS-IV), Guilford Press."},{"key":"ref_35","first-page":"357","article-title":"Gender differences in attention-deficit\/hyperactivity disorder","volume":"33","author":"Rucklidge","year":"2010","journal-title":"Psychiatr. Clin."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1037\/a0032247","article-title":"Sexual selection and sex differences in the prevalence of childhood externalizing and adolescent internalizing disorders","volume":"139","author":"Martel","year":"2013","journal-title":"Psychol. Bull."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1037\/0022-006X.74.1.179","article-title":"Should sex-specific norms be used to assess attention-deficit\/hyperactivity disorder or oppositional defiant disorder?","volume":"74","author":"Waschbusch","year":"2006","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s11920-024-01492-6","article-title":"Sex differences in ADHD: Review and priorities for future research","volume":"26","author":"Babinski","year":"2024","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e12721","DOI":"10.1111\/desc.12721","article-title":"Sex differences in ADHD trajectories across childhood and adolescence","volume":"22","author":"Murray","year":"2019","journal-title":"Dev. Sci."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Young, S., Adamo, N., \u00c1sgeirsd\u00f3ttir, B.B., Branney, P., Beckett, M., Colley, W., Cubbin, S., Deeley, Q., Farrag, E., and Gudjonsson, G. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit\/hyperactivity disorder in girls and women. BMC Psychiatry, 20.","DOI":"10.1186\/s12888-020-02707-9"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1192\/bjp.2020.200","article-title":"The neurodevelopmental nature of attention-deficit hyperactivity disorder in adults","volume":"218","author":"Breda","year":"2021","journal-title":"Br. J. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/jcpp.13020","article-title":"Annual Research Review: Does late-onset attention-deficit\/hyperactivity disorder exist?","volume":"60","author":"Asherson","year":"2019","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1111\/jcpp.12988","article-title":"Investigating the childhood symptom profile of community-based individuals diagnosed with attention-deficit\/hyperactivity disorder as adults","volume":"60","author":"Taylor","year":"2019","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.jaac.2016.04.004","article-title":"Is there a female protective effect against attention-deficit\/hyperactivity disorder? Evidence from two representative twin samples","volume":"55","author":"Taylor","year":"2016","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1177\/10870547211066486","article-title":"\u201cLate-onset\u201d ADHD symptoms in young adulthood: Is this ADHD?","volume":"26","author":"Riglin","year":"2022","journal-title":"J. Atten. Disord."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1111\/jcpp.13574","article-title":"ADHD in girls and women: A call to action\u2013reflections on Hinshaw et al. (2021)","volume":"63","year":"2022","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1007\/s00787-016-0831-8","article-title":"Predictors of persistence of ADHD into adulthood: A systematic review of the literature and meta-analysis","volume":"25","author":"Caye","year":"2016","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"7626","DOI":"10.4088\/JCP.14m09630","article-title":"Gender differences in adult attention-deficit\/hyperactivity disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)","volume":"77","author":"Cortese","year":"2016","journal-title":"J. Clin. Psychiatry"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1177\/10870547241251738","article-title":"Sex differences in diagnosis and treatment timing of comorbid depression\/anxiety and disease subtypes in patients with ADHD: A database study","volume":"28","author":"Siddiqui","year":"2024","journal-title":"J. Atten. Disord."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1111\/jcpp.13987","article-title":"Sex differences in attention-deficit hyperactivity disorder diagnosis and clinical care: A national study of population healthcare records in Wales","volume":"65","author":"Martin","year":"2024","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.psychres.2018.12.128","article-title":"Do different factors influence whether girls versus boys meet ADHD diagnostic criteria? Sex differences among children with high ADHD symptoms","volume":"272","author":"Mowlem","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1177\/1087054710381481","article-title":"Exploring the gender gap in referrals for children with ADHD and other disruptive behavior disorders","volume":"16","author":"Coles","year":"2012","journal-title":"J. Atten. Disord."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1176\/appi.ajp.2013.13070966","article-title":"Emotion dysregulation in attention deficit hyperactivity disorder","volume":"171","author":"Shaw","year":"2014","journal-title":"Am. J. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Kao, P.-H., Ho, C.-H., and Huang, C.L.-C. (2025). Sex differences in psychiatric comorbidities of attention-deficit\/hyperactivity disorder among children, adolescents, and adults: A nationwide population-based cohort study. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0315587"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"i15","DOI":"10.1007\/s00787-006-1003-z","article-title":"Influence of gender on attention-deficit\/hyperactivity disorder in Europe\u2013ADORE","volume":"15","author":"Hervas","year":"2006","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/00004583-200502000-00008","article-title":"Gender differences among children with DSM-IV ADHD in Australia","volume":"44","author":"Graetz","year":"2005","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/YCO.0000000000000770","article-title":"Towards equitable diagnoses for autism and attention-deficit\/hyperactivity disorder across sexes and genders","volume":"35","author":"Lai","year":"2022","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s00787-005-0438-y","article-title":"Informant, gender and age differences in ratings of adolescent problem behaviour","volume":"14","author":"Verhulst","year":"2005","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1007\/s00787-023-02308-3","article-title":"Pervasive versus situational childhood ADHD: Latent classes and their clinical characteristics, based on parent and teacher ratings in a large longitudinal population sample","volume":"33","author":"Frick","year":"2024","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1111\/1469-7610.00440","article-title":"DSM-IV AD\/HD: Confirmatory factor models, prevalence, and gender and age differences based on parent and teacher ratings of Australian primary school children","volume":"40","author":"Gomez","year":"1999","journal-title":"J. Child Psychol. Psychiatry Allied Discip."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/j.1475-3588.2012.00653.x","article-title":"Teachers\u2019 recognition of children with ADHD: Role of subtype and gender","volume":"18","author":"Moldavsky","year":"2013","journal-title":"Child Adolesc. Ment. Health"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/j.biopsych.2003.12.003","article-title":"Gender effects on attention-deficit\/hyperactivity disorder in adults, revisited","volume":"55","author":"Biederman","year":"2004","journal-title":"Biol. Psychiatry"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s40732-021-00474-x","article-title":"Using the IRAP to investigate gender biases towards ADHD and anxiety","volume":"72","author":"Nolan","year":"2022","journal-title":"Psychol. Rec."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s11920-008-0067-5","article-title":"Attention-deficit\/hyperactivity disorder and its comorbidities in women and girls: An evolving picture","volume":"10","author":"Quinn","year":"2008","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Chen, Q., Hartman, C.A., Haavik, J., Harro, J., Klungs\u00f8yr, K., Hegvik, T.-A., Wanders, R., Ottosen, C., Dalsgaard, S., and Faraone, S.V. (2018). Common psychiatric and metabolic comorbidity of adult attention-deficit\/hyperactivity disorder: A population-based cross-sectional study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204516"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"100","DOI":"10.3934\/publichealth.2014.2.100","article-title":"A pilot study examining ADHD and Behavioural disturbance in female mentally disordered offenders","volume":"1","author":"Hollingdale","year":"2014","journal-title":"AIMS Public Health"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s10802-011-9530-6","article-title":"Trajectories of attention deficit hyperactivity disorder and oppositional defiant disorder symptoms as precursors of borderline personality disorder symptoms in adolescent girls","volume":"40","author":"Stepp","year":"2012","journal-title":"J. Abnorm. Child Psychol."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Petrovic, P., and Castellanos, F.X. (2016). Top-down dysregulation\u2014From ADHD to emotional instability. Front. Behav. Neurosci., 10.","DOI":"10.3389\/fnbeh.2016.00070"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1080\/08039488.2020.1850859","article-title":"The road to diagnosis and treatment in girls and boys with ADHD\u2013gender differences in the diagnostic process","volume":"75","author":"Kantzer","year":"2021","journal-title":"Nord. J. Psychiatry"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S0149-7634(99)00044-5","article-title":"Sex differences in dopamine receptors and their relevance to ADHD","volume":"24","author":"Andersen","year":"2000","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/BF02088099","article-title":"Estrogen control of central neurotransmission: Effect on mood, mental state, and memory","volume":"16","author":"Fink","year":"1996","journal-title":"Cell. Mol. Neurobiol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1111\/jcpp.14023","article-title":"Hidden in plain sight: Delayed ADHD diagnosis among girls and women\u2013a commentary on Skoglund et al. (2023)","volume":"65","year":"2024","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jpsychires.2020.12.005","article-title":"Prevalence of hormone-related mood disorder symptoms in women with ADHD","volume":"133","author":"Dorani","year":"2021","journal-title":"J. Psychiatr. Res."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"18m12548","DOI":"10.4088\/JCP.18m12548","article-title":"Sex and pubertal status moderate the association between ADHD and depression symptoms: An examination from preadolescence through late adolescence","volume":"80","author":"Babinski","year":"2019","journal-title":"J. Clin. Psychiatry"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00737-021-01181-w","article-title":"Relationship between sex hormones, reproductive stages and ADHD: A systematic review","volume":"25","author":"Camara","year":"2022","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1111\/jcpp.13920","article-title":"Time after time: Failure to identify and support females with ADHD\u2013a Swedish population register study","volume":"65","author":"Skoglund","year":"2024","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1007\/s00787-023-02244-2","article-title":"First-time diagnosis of ADHD in adults: Challenge to retrospectively assess childhood symptoms of ADHD from long-term memory","volume":"32","author":"Waltereit","year":"2023","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1192\/bjp.2025.10376","article-title":"Reflections on the manifestation of attention-deficit hyperactivity disorder in girls from young adults with lived experiences: A qualitative study","volume":"227","author":"Williams","year":"2025","journal-title":"Br. J. Psychiatry"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1177\/10870547231161533","article-title":"Miss. Diagnosis: A systematic review of ADHD in adult women","volume":"27","author":"Attoe","year":"2023","journal-title":"J. Atten. Disord."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e1923","DOI":"10.1002\/mpr.1923","article-title":"Attention-deficit\/hyperactivity disorder (ADHD) in cultural context: Do parents in Hong Kong and the United Kingdom adopt different thresholds when rating symptoms, and if so why?","volume":"31","author":"Chan","year":"2022","journal-title":"Int. J. Methods Psychiatr. Res."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1080\/15374410903103627","article-title":"Why is there a gender gap in children presenting for attention deficit\/hyperactivity disorder services?","volume":"38","author":"Ohan","year":"2009","journal-title":"J. Clin. Child Adolesc. Psychol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1111\/jcpp.12398","article-title":"Practitioner review: Pathways to care for ADHD\u2013a systematic review of barriers and facilitators","volume":"56","author":"Wright","year":"2015","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1111\/1467-9566.13817","article-title":"Parental illness work across the attention deficit hyperactivity disorder diagnostic journey","volume":"46","author":"Nicholson","year":"2024","journal-title":"Sociol. Health Illn."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6804\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:37:04Z","timestamp":1788496624000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":83,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15176804"],"URL":"https:\/\/doi.org\/10.3390\/jcm15176804","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}