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Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales
Journal of Child Psychology and Psychiatry
Swansea University Authors:
Olivier Rouquette , Ann John
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DOI (Published version): 10.1111/jcpp.13987
Abstract
BackgroundPopulation-based studies have observed sex biases in the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD). Females are less likely to be diagnosed or prescribed ADHD medication. This study uses national healthcare records, to investigate sex differences in diagnos...
Published in: | Journal of Child Psychology and Psychiatry |
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ISSN: | 0021-9630 1469-7610 |
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Wiley
2024
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URI: | https://cronfa.swan.ac.uk/Record/cronfa66081 |
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<?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>66081</id><entry>2024-04-18</entry><title>Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales</title><swanseaauthors><author><sid>0e502db88ea48ce6b053ed0eef9a54ce</sid><ORCID>0000-0001-8088-4800</ORCID><firstname>Olivier</firstname><surname>Rouquette</surname><name>Olivier Rouquette</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>ed8a9c37bd7b7235b762d941ef18ee55</sid><ORCID>0000-0002-5657-6995</ORCID><firstname>Ann</firstname><surname>John</surname><name>Ann John</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-04-18</date><deptcode>MEDS</deptcode><abstract>BackgroundPopulation-based studies have observed sex biases in the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD). Females are less likely to be diagnosed or prescribed ADHD medication. This study uses national healthcare records, to investigate sex differences in diagnosis and clinical care in young people with ADHD, particularly regarding recognition and treatment of other mental health conditions.MethodsThe cohort included individuals diagnosed with ADHD, born between 1989 and 2013 and living in Wales between 2000 and 2019. Routine primary and secondary healthcare record data were used to derive diagnoses of ADHD and other neurodevelopmental and mental health conditions, as well as ADHD and antidepressant medications. Demographic variables included ethnicity, socioeconomic deprivation and contact with social services.ResultsThere were 16,458 individuals diagnosed with ADHD (20.3% females, ages 3–30 years), with a male-to-female ratio of 3.9:1. Higher ratios (4.8:1) were seen in individuals diagnosed younger (<12 years), with the lowest ratio (1.9:1) in those diagnosed as adults (>18). Males were younger at first recorded ADHD diagnosis (mean = 10.9 vs. 12.6 years), more likely to be prescribed ADHD medication and younger at diagnosis of co-occurring neurodevelopmental conditions. In contrast, females were more likely to receive a diagnosis of anxiety, depression or another mental health condition and to be prescribed antidepressant medications, prior to ADHD diagnosis. These sex differences were largely stable across demographic groups.ConclusionsThis study adds to the evidence base that females with ADHD are experiencing later recognition and treatment of ADHD. The results indicate that this may be partly because of diagnostic overshadowing from other mental health conditions, such as anxiety and depression, or initial misdiagnosis. Further research and dissemination of findings to the public are needed to improve awareness, timely diagnosis and treatment of ADHD in females.</abstract><type>Journal Article</type><journal>Journal of Child Psychology and Psychiatry</journal><volume>0</volume><journalNumber/><paginationStart/><paginationEnd/><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0021-9630</issnPrint><issnElectronic>1469-7610</issnElectronic><keywords>ADHD; sex differences; neurodevelopmental conditions; mental health</keywords><publishedDay>12</publishedDay><publishedMonth>6</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-06-12</publishedDate><doi>10.1111/jcpp.13987</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>Brain and Behavior Research Foundation. Grant Number: 27879
Health and Care Research Wales. Grant Number: NIHR-FS(A)-2022</funders><projectreference/><lastEdited>2024-06-26T17:02:59.1203301</lastEdited><Created>2024-04-18T12:41:33.4545599</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Joanna</firstname><surname>Martin</surname><orcid>0000-0002-8911-3479</orcid><order>1</order></author><author><firstname>Kate</firstname><surname>Langley</surname><orcid>0000-0002-2033-2657</orcid><order>2</order></author><author><firstname>Miriam</firstname><surname>Cooper</surname><orcid>0000-0002-4695-5481</orcid><order>3</order></author><author><firstname>Olivier</firstname><surname>Rouquette</surname><orcid>0000-0001-8088-4800</orcid><order>4</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>5</order></author><author><firstname>Kapil</firstname><surname>Sayal</surname><orcid>0000-0002-2050-4316</orcid><order>6</order></author><author><firstname>Tamsin</firstname><surname>Ford</surname><orcid>0000-0001-5295-4904</orcid><order>7</order></author><author><firstname>Anita</firstname><surname>Thapar</surname><orcid>0000-0002-3689-737x</orcid><order>8</order></author></authors><documents><document><filename>66081__30763__6af210aa05f1406bbbe60f3785171b0e.pdf</filename><originalFilename>66081.VoR.pdf</originalFilename><uploaded>2024-06-26T17:00:11.4560836</uploaded><type>Output</type><contentLength>866299</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright: 2024 The Author(s). This is an open access article under the terms of the Creative Commons Attribution License.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807> |
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v2 66081 2024-04-18 Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales 0e502db88ea48ce6b053ed0eef9a54ce 0000-0001-8088-4800 Olivier Rouquette Olivier Rouquette true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2024-04-18 MEDS BackgroundPopulation-based studies have observed sex biases in the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD). Females are less likely to be diagnosed or prescribed ADHD medication. This study uses national healthcare records, to investigate sex differences in diagnosis and clinical care in young people with ADHD, particularly regarding recognition and treatment of other mental health conditions.MethodsThe cohort included individuals diagnosed with ADHD, born between 1989 and 2013 and living in Wales between 2000 and 2019. Routine primary and secondary healthcare record data were used to derive diagnoses of ADHD and other neurodevelopmental and mental health conditions, as well as ADHD and antidepressant medications. Demographic variables included ethnicity, socioeconomic deprivation and contact with social services.ResultsThere were 16,458 individuals diagnosed with ADHD (20.3% females, ages 3–30 years), with a male-to-female ratio of 3.9:1. Higher ratios (4.8:1) were seen in individuals diagnosed younger (<12 years), with the lowest ratio (1.9:1) in those diagnosed as adults (>18). Males were younger at first recorded ADHD diagnosis (mean = 10.9 vs. 12.6 years), more likely to be prescribed ADHD medication and younger at diagnosis of co-occurring neurodevelopmental conditions. In contrast, females were more likely to receive a diagnosis of anxiety, depression or another mental health condition and to be prescribed antidepressant medications, prior to ADHD diagnosis. These sex differences were largely stable across demographic groups.ConclusionsThis study adds to the evidence base that females with ADHD are experiencing later recognition and treatment of ADHD. The results indicate that this may be partly because of diagnostic overshadowing from other mental health conditions, such as anxiety and depression, or initial misdiagnosis. Further research and dissemination of findings to the public are needed to improve awareness, timely diagnosis and treatment of ADHD in females. Journal Article Journal of Child Psychology and Psychiatry 0 Wiley 0021-9630 1469-7610 ADHD; sex differences; neurodevelopmental conditions; mental health 12 6 2024 2024-06-12 10.1111/jcpp.13987 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee Brain and Behavior Research Foundation. Grant Number: 27879 Health and Care Research Wales. Grant Number: NIHR-FS(A)-2022 2024-06-26T17:02:59.1203301 2024-04-18T12:41:33.4545599 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Joanna Martin 0000-0002-8911-3479 1 Kate Langley 0000-0002-2033-2657 2 Miriam Cooper 0000-0002-4695-5481 3 Olivier Rouquette 0000-0001-8088-4800 4 Ann John 0000-0002-5657-6995 5 Kapil Sayal 0000-0002-2050-4316 6 Tamsin Ford 0000-0001-5295-4904 7 Anita Thapar 0000-0002-3689-737x 8 66081__30763__6af210aa05f1406bbbe60f3785171b0e.pdf 66081.VoR.pdf 2024-06-26T17:00:11.4560836 Output 866299 application/pdf Version of Record true Copyright: 2024 The Author(s). This is an open access article under the terms of the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/ |
title |
Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales |
spellingShingle |
Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales Olivier Rouquette Ann John |
title_short |
Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales |
title_full |
Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales |
title_fullStr |
Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales |
title_full_unstemmed |
Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales |
title_sort |
Sex differences in attention‐deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales |
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0e502db88ea48ce6b053ed0eef9a54ce ed8a9c37bd7b7235b762d941ef18ee55 |
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0e502db88ea48ce6b053ed0eef9a54ce_***_Olivier Rouquette ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John |
author |
Olivier Rouquette Ann John |
author2 |
Joanna Martin Kate Langley Miriam Cooper Olivier Rouquette Ann John Kapil Sayal Tamsin Ford Anita Thapar |
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Journal of Child Psychology and Psychiatry |
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2024 |
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10.1111/jcpp.13987 |
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Wiley |
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Faculty of Medicine, Health and Life Sciences |
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Faculty of Medicine, Health and Life Sciences |
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Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science |
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BackgroundPopulation-based studies have observed sex biases in the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD). Females are less likely to be diagnosed or prescribed ADHD medication. This study uses national healthcare records, to investigate sex differences in diagnosis and clinical care in young people with ADHD, particularly regarding recognition and treatment of other mental health conditions.MethodsThe cohort included individuals diagnosed with ADHD, born between 1989 and 2013 and living in Wales between 2000 and 2019. Routine primary and secondary healthcare record data were used to derive diagnoses of ADHD and other neurodevelopmental and mental health conditions, as well as ADHD and antidepressant medications. Demographic variables included ethnicity, socioeconomic deprivation and contact with social services.ResultsThere were 16,458 individuals diagnosed with ADHD (20.3% females, ages 3–30 years), with a male-to-female ratio of 3.9:1. Higher ratios (4.8:1) were seen in individuals diagnosed younger (<12 years), with the lowest ratio (1.9:1) in those diagnosed as adults (>18). Males were younger at first recorded ADHD diagnosis (mean = 10.9 vs. 12.6 years), more likely to be prescribed ADHD medication and younger at diagnosis of co-occurring neurodevelopmental conditions. In contrast, females were more likely to receive a diagnosis of anxiety, depression or another mental health condition and to be prescribed antidepressant medications, prior to ADHD diagnosis. These sex differences were largely stable across demographic groups.ConclusionsThis study adds to the evidence base that females with ADHD are experiencing later recognition and treatment of ADHD. The results indicate that this may be partly because of diagnostic overshadowing from other mental health conditions, such as anxiety and depression, or initial misdiagnosis. Further research and dissemination of findings to the public are needed to improve awareness, timely diagnosis and treatment of ADHD in females. |
published_date |
2024-06-12T17:02:58Z |
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11.021648 |