Summary of narrative review
A systematic review and meta-analysis on the prevalence of ADHD in incarcerated individuals from 42 studies found 30% of youth and 26% of adults in prison had ADHD (Young, Moss, Sedgwick, Fridman, & Hodgkins, 2015b), echoed in a more recent review (Baggio et al., 2018). There is a high prevalence of ADHD in children and adolescents with mood disorders including bipolar and major depressive disorder (Sandstrom, Perroud, Alda, Uher, & Pavlova, 2021) and in adolescents with substance use (Lange, Rehm, Anagnostou, & Popova, 2018). Children and adolescents at higher risk of ADHD also include those with language disorders (Korrel, Mueller, Silk, Anderson, & Sciberras, 2017) and those with specific learning disorders (Boada, Willcutt, & Pennington, 2012; Morsanyi, van Bers, McCormack, & McGourty, 2018).
Around half of people with foetal alcohol spectrum disorder may have ADHD (Lange, Rehm, et al., 2018). People with acquired brain injury have higher rates of premorbid ADHD (Ilie et al., 2015). Low birth weight has also been associated with an increased risk of ADHD (Momany, Kamradt, & Nikolas, 2018). There also may be higher prevalence of ADHD in people with eating disorders such as binge eating disorders than that found in the general population (Wentz et al., 2005; Yates, Lund, Johnson, Mitchell, & McKee, 2009). Similarly, there is an increased risk of ADHD among people with sleep disorders (Cortese, Faraone, Konofal, & Lecendreux, 2009; Sedky, Bennett, & Carvalho, 2014), or problem gambling (Dowling et al., 2015).
Evidence also suggests that girls and women with ADHD may frequently go unrecognised or be diagnosed late (Hinshaw, Nguyen, O’Grady, & Rosenthal, 2021; Quinn & Madhoo, 2014), with a lower gender ratio in adulthood-diagnosed versus childhood-diagnosed ADHD (May, Aizenstros, & Aizenstros, 2021). This difference may be due to various factors including a low clinical suspicion for girls, in whom inattentive symptoms may be more prominent than hyperactivity-impulsivity symptoms (Quinn & Madhoo, 2014). Girls and women with ADHD may experience high levels of emotion dysregulation and sometimes receive other diagnoses such as anxiety and depression (Quinn & Madhoo, 2014).
Parents may under-recognise hyperactivity-impulsivity symptoms in girls, or a diagnosis might be made in girls only when other co-occurring emotional or externalising symptoms are present (Mowlem, Agnew-Blais, Taylor, & Asherson, 2019). The symptoms of ADHD may also vary during the menstrual cycle, and reproductive stages such as pregnancy and menopause (Haimov-Kochman & Berger, 2014; Roberts, Eisenlohr-Moul, & Martel, 2018), although evidence is currently limited (Camara, Padoin, & Bolea, 2021). This should be considered during the diagnosis and treatment of ADHD in women and girls.