ADULT ADHD IN WOMEN MISDIAGNOSED AS DEPRESSION: DIAGNOSTIC CHALLENGES, CLINICAL CONSEQUENCES AND IMPLICATIONS FOR HEALTHCARE EDUCATION – A NARRATIVE REVIEW

Authors

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.5946

Keywords:

Adult ADHD, Women, Misdiagnosis, Depression, Diagnostic Delay, Masking, Differential Diagnosis

Abstract

Background. Attention-deficit/hyperactivity disorder (ADHD) in adult women remains substantially underdiagnosed and frequently misinterpreted as depressive disorders. This diagnostic inaccuracy is associated with gender-specific symptom presentation, internalization of difficulties, and compensatory masking strategies.

Aim. The aim of this narrative review is to examine the mechanisms underlying the misdiagnosis of ADHD as depression in adult women, identify key diagnostic challenges, evaluate clinical consequences, and discuss implications for healthcare education.

Material and methods. A narrative review of 30 peer-reviewed articles published between 2009 and 2026 was conducted. Databases including PubMed and Google Scholar were searched using keywords related to adult ADHD, women, depression, and misdiagnosis.

Results. Evidence indicates that adult women with ADHD are frequently misdiagnosed with depressive disorders due to overlapping symptoms such as fatigue, impaired concentration, and emotional dysregulation. Gender-specific factors, including social expectations and masking behaviors, significantly delay diagnosis. Misdiagnosis results in inappropriate pharmacological treatment, chronic functional impairment, and increased psychiatric comorbidity.

Conclusions. ADHD in women requires a gender-sensitive diagnostic approach. Increased clinician awareness and improved training in differential diagnosis are essential to reduce misdiagnosis and improve patient outcomes.

References

Anbarasan, D., Kitchin, M., & Adler, L. A. (2020). Screening for adult ADHD. Current Psychiatry Reports, 22(12), 72. https://doi.org/10.1007/s11920-020-01194-9

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596

Attoe, D. E., & Climie, E. A. (2023). Miss. Diagnosis: A systematic review of ADHD in adult women. Journal of Attention Disorders, 27(7), 645–657. https://doi.org/10.1177/10870547231161533

Babinski, D. E., & Libsack, E. J. (2025). Adult diagnosis of ADHD in women: A mixed methods investigation. Journal of Attention Disorders, 29(3), 207–219. https://doi.org/10.1177/10870547241297897

Bron, T. I., Bijlenga, D., Verduijn, J., et al. (2016). Prevalence of ADHD symptoms across clinical stages of major depressive disorder. Journal of Affective Disorders, 197, 29–35. https://doi.org/10.1016/j.jad.2016.02.053

Da Silva, A. G., Malloy-Diniz, L. F., Garcia, M. S., & Rocha, R. (2020). Attention-deficit/hyperactivity disorder and women. In Women’s mental health (pp. 215–219). Springer. https://doi.org/10.1007/978-3-030-29081-8

Faltinsen, E., Zwi, M., Castells, X., et al. (2019). Updated 2018 NICE guideline on pharmacological treatments for people with ADHD: A critical look. BMJ Evidence-Based Medicine, 24(3), 99–102. https://doi.org/10.1136/bmjebm-2018-111110

Fuller-Thomson, E., Lewis, D. A., & Agbeyaka, S. K. (2016). ADHD in adult women: Population-based findings. The Child, 42(6), 918–927. https://doi.org/10.1111/cch.12380

Fu, X., Wu, W., Wu, Y., et al. (2025). Adult ADHD and comorbid anxiety and depressive disorders. Frontiers in Psychiatry, 16, 1597559. https://doi.org/10.3389/fpsyt.2025.1597559

Henry, E., & Jones, S. H. (2011). Experiences of older adult women diagnosed with ADHD. Journal of Women & Aging, 23(3), 246–262. https://doi.org/10.1080/08952841.2011.589285

Holden, E., & Kobayashi-Wood, H. (2025). Adverse experiences of women with undiagnosed ADHD and the role of diagnosis. Scientific Reports, 15, 20945. https://doi.org/10.1038/s41598-025-04782-y

Holthe, M. E. G., & Langvik, E. (2017). The strives, struggles, and successes of women diagnosed with ADHD as adults. Sage Open, 7(1). https://doi.org/10.1177/2158244017701799

Kooij, J. J. S., et al. (2019). Updated European consensus statement on diagnosis and treatment of adult ADHD. European Psychiatry, 56, 14–34. https://doi.org/10.1016/j.eurpsy.2018.11.001

Krebs, K., & Donnellan-Fernandez, R. (2025). The impact of ADHD across women’s lifespan: An integrative review. BMC Women’s Health, 25, 593. https://doi.org/10.1186/s12905-025-04123-1

Lynch, A., & Davison, K. (2022). Gendered expectations on the recognition of ADHD in young women. Irish Educational Studies. https://doi.org/10.1080/03323315.2022.2032264

Martin, J. (2024). Why are females less likely to be diagnosed with ADHD in childhood than males? The Lancet Psychiatry, 11(4), 303–310. https://doi.org/10.1016/S2215-0366(24)00010-5

McIntosh, D., Kutcher, S., Binder, C., et al. (2009). Adult ADHD and comorbid depression: A diagnostic algorithm. Neuropsychiatric Disease and Treatment, 5, 137–150. https://doi.org/10.2147/NDT.S4720

Morgan, J. (2024). Exploring women’s experiences of ADHD diagnosis in adulthood. Advances in Mental Health, 22(3), 575–589. https://doi.org/10.1080/18387357.2023.2268756

Mylett, M. L., Boucher, T. Q., & Iarocci, G. (2026). Social camouflaging in adults with ADHD. Research in Neurodiversity, 100018. https://doi.org/10.1016/j.rin.2026.100018

Nussbaum, N. L. (2012). ADHD and female-specific concerns. Journal of Attention Disorders, 16(2), 87–100. https://doi.org/10.1177/1087054711416909

Paucke, M., Stibbe, T., Huang, J., & Strauss, M. (2021). Differentiation of ADHD and depression based on cognitive performance. Journal of Attention Disorders, 25(7), 920–932. https://doi.org/10.1177/1087054719865780

Powell, V., Agha, S. S., Bevan Jones, R., et al. (2021). ADHD in adults with recurrent depression. Journal of Affective Disorders, 295, 1153–1160. https://doi.org/10.1016/j.jad.2021.09.010

Quinn, P. O., & Madhoo, M. (2014). ADHD in women and girls. Primary Care Companion for CNS Disorders, 16(3), PCC.13r01596. https://doi.org/10.4088/PCC.13r01596

Sibley, M. H. (2021). Guidelines for first-time adult ADHD diagnosis. Journal of Clinical and Experimental Neuropsychology, 43(4), 340–351. https://doi.org/10.1080/13803395.2021.1903418

Thapar, A., & Cooper, M. (2015). Attention deficit hyperactivity disorder. The Lancet, 387, 1240–1250. https://doi.org/10.1016/S0140-6736(14)61684-7

Ustun, B., Adler, L. A., Rudin, C., et al. (2017). WHO adult ADHD screening scale. JAMA Psychiatry, 74(5), 520–526. https://doi.org/10.1001/jamapsychiatry.2017.0298

Willcutt, E. G., Nigg, J. T., Pennington, B. F., et al. (2012). Validity of ADHD symptom dimensions. Journal of Abnormal Psychology, 121, 991–1010. https://doi.org/10.1037/a0027347

Williams, T., et al. (2025). Manifestation of ADHD in girls: lived experience study. The British Journal of Psychiatry, 227(5), 775–782. https://doi.org/10.1192/bjp.2025.10376

Yavuzlar Civan, H., & Berkol, T. D. (2025). ADHD comorbidity in women with depression and anxiety. International Journal of Psychiatry in Medicine. https://doi.org/10.1177/00912174251376111

Young, S., Adamo, N., Ásgeirsdóttir, B. B., et al. (2020). Females with ADHD: Expert consensus statement. BMC Psychiatry, 20, 404. https://doi.org/10.1186/s12888-020-02707-9

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Published

2026-09-16

How to Cite

Tomaszewska, A. J., Kaczmarek, M., Pojawa, M., Chudzik, A., Prządka, J., Buzek, E., & Witkowska, W. (2026). ADULT ADHD IN WOMEN MISDIAGNOSED AS DEPRESSION: DIAGNOSTIC CHALLENGES, CLINICAL CONSEQUENCES AND IMPLICATIONS FOR HEALTHCARE EDUCATION – A NARRATIVE REVIEW. International Journal of Innovative Technologies in Social Science, 4(3(51). https://doi.org/10.31435/ijitss.3(51).2026.5946

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