Impaired health-related quality of life, and depressive symptoms in a cohort of healthy adults with symptoms of attention deficit/hyperactivity disorder

• DOI: 10.1192/j.eurpsy.2025.30
• Publication Date: 2025-03-03T09:14:21Z
• Authors: Annemette Hald; Ole Birger Pedersen; Kristoffer Sølvst...; Lise W. Thørner; Christina Mikkelsen; Lea A.N. Christof...; Henrik Ullum; Henrik Hjalgrim; Christian Erikstrup; Mie T. Bruun; Bitten Aagaard; Susan Mikkelsen; Thomas F. Hansen; Thomas Werge; Andrew J. Schork; Sisse Rye Ostrowski; Maria Didriksen

Abstract

Background Attention deficit/hyperactivity disorder (ADHD) prevalence has increased in the last 10 years, most likely due to increased recognition by clinicians. Even so, an issue with under-diagnostics may persist. Historically ADHD has been described as a male-dominant disorder. However, recent evidence shows that ADHD prevalence is similar between the sexes, but that the related impairment or symptomatology might vary. This study estimated the prevalence of undiagnosed ADHD symptoms (pADHD) and explored the sex-stratified symptomatology and associations with self-perceived health-related quality of life (HRQL) and experience of depressive symptoms.

Methods This was done in a unique cohort of 50,937 healthy blood donors – individuals who successfully maintain regular commitments despite potential ADHD symptoms. ADHD symptoms were estimated using the Adult ADHD Self-Report Scale (ASRS), health-related quality of life (HRQL) measured using mental and physical component scores (MCS/PCS) estimated based on a 12-item Short-Form Health Survey (SF-12) with a higher score indicating better HRQL, and depressive symptoms were measured using Major Depression Inventory (MDI) with higher score indicating more depressive symptoms.

Results In total, 3% were classified with pADHD (sex ratio 1:1). pADHD was associated with reduced MCS and PCS, and increased MDI score. Males scored on average higher on inattentive symptoms compared to females, whereas females scored on average higher on hyperactive-impulsive symptoms. Individuals scoring high on the combined inattentive and hyperactive-impulsive ADHD symptom presentation were most likely to be impaired in terms of higher MDI scores and lower PCS when compared to non-ADHD controls.

Conclusions In conclusion, ADHD symptoms are common in this seemingly healthy and undiagnosed population. Symptom presentations differ between sexes and the type of presentation seems to impact the association with depressive symptoms and level of reduced HRQL.