Differences between males and females in long-term outcomes of adults diagnosed with ADHD in childhood

Background. Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder, with increased risk for negative adult long-term outcomes. These outcomes may differ between males and females with ADHD, but whether these differences are more pronounced in ADHD or similar to those in the general population remains unclear. Method. In an 18-year follow-up of 283 children (Mage = 28.48) we assessed if sex moderated 51 long-term outcomes across 7 domains: psychiatric status, behavioral/emotional problems, academic/professional functioning, adaptive functioning, neurocognition, physical health, and healthcare service use in those with ADHD (nfemales = 50, nmales = 104), and without ADHD (nfemales = 77, nmales = 52). Additionally, we aimed to explore the moderating role of gender-expression. Results. Sex interacted with group for social functioning: males with ADHD were more likely to show lower social functioning compared to females with ADHD and controls. There were no sex differences on the other outcomes. As sex and gender-expression were highly similar (r = .94), specific effects of gender-expression could not be studied. Conclusions. Generally, sex did not have a more pronounced effect on long-term outcomes of childhood ADHD in individuals with ADHD compared to the general population. Gender-expression could not be studied in our predominantly cisgendered sample.