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Influence of sex and depressive symptoms on diagnostic delay of attention deficit hyperactivity disorder in adolescent psychiatric patients
Örebro Univ, Dept Med Sci, Örebro, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research, County of Västmanland.ORCID iD: 0000-0002-8853-2508
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Child and Adolescent Psychiatry.ORCID iD: 0000-0001-8203-8755
Örebro Univ, Dept Med Sci, Örebro, Sweden..
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2026 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 80, no 1, p. 35-41Article in journal (Refereed) Published
Abstract [en]

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonneurodevelopmental disorders in adolescence resulting in functional impairment that often persist toadulthood. Girls seem to be diagnosed with ADHD later in life than boys and more often have acomorbid major depressive disorder (MDD). It has been suggested that comorbidity with MDD caninterfere with early identification of ADHD.Aims: The aim of the study was to investigate the diagnostic delay for boys and girls with ADHD inchild and adolescent outpatient settings as well the interference of self-reported symptoms of MDD.Methods: Adolescent psychiatric outpatients were assessed with DSRS-A Screener (version of DepressionSelf-Rating Scale for Adolescents) at intake. Diagnostic delay for ADHD was estimated with Kaplan-Meiersurvival curve with separated analysis for boys/girls and for negative/positive MDD screening. Coxregression analysis was used to examine the association of sex and MDD screening.Results: Diagnostic delay for N = 252 (41% boys, mean age =15.23 years) was 3.5 years, 1.4 for boys and4.9 for girls (p = 0.004). Positive MDD screening was associated with prolonged diagnostic delay (from1.4 to 4.9 years p = 0.002), which in separated analyses was statistically significant only for girls from 1.8to 4.9 years (p = 0.018). In Cox regression male sex was associated with decreased diagnostic delay(p = 0.023) while positive MDD screening with prolonged diagnostic delay (p = 0.015).Conclusions: The diagnostic delay of ADHD was more than three times longer for girls. Co-occurringsymptoms of MDD prolonged diagnostic delay significantly only for girls.

Place, publisher, year, edition, pages
Taylor & Francis, 2026. Vol. 80, no 1, p. 35-41
Keywords [en]
ADHD, depression, adolescents, sex differences
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-582773DOI: 10.1080/08039488.2025.2588759ISI: 001618745100001PubMedID: 41255090Scopus ID: 2-s2.0-105022433290OAI: oai:DiVA.org:uu-582773DiVA, id: diva2:2049586
Available from: 2026-03-30 Created: 2026-03-30 Last updated: 2026-03-30Bibliographically approved

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Nilsson, KentRamklint, MiaSonnby, Karin

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