Bias by gender: exploring gender-based differences in the endorsement of ADHD symptoms and impairment among adult patients

Background: Research on adult attention-deficit/hyperactivity disorder (ADHD) remains limited, particularly regarding the experiences of women. Methods: This exploratory study investigates patient responses to the Diagnostic Interview for ADHD in Adults (DIVA-5), which assesses current (adult) and retrospective (childhood) ADHD symptoms based on criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). We focused on overall endorsement rates of ADHD symptoms, impairments, and specific examples of both, with particular attention to gender differences. Using descriptive statistics and chi-square tests, we analysed existing DIVA-5 data from 2,257 adult patients diagnosed with ADHD at mental health clinics affiliated with the Parnassia Groep in the Netherlands. Results: Our findings indicate that ADHD manifests similarly across men and women, though subtle differences in symptom and impairment patterns emerged. Women more frequently endorsed several inattentive and hyperactive/impulsive symptoms in adulthood, whereas men reported higher endorsement rates of several childhood symptoms. Regarding impairments, gender-specific patterns were observed in areas such as self-esteem and social relationships. Conclusion: While these differences were small, they highlight the need for further investigation into gendered ADHD manifestations. Additionally, we discuss potential measurement limitations and propose recommendations for refining the DIVA-5 and advancing research on gender differences in ADHD.