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Julia Wilson, BA




Research Staff


Brigham and Women's Hospital


Psychiatry/Connors Center for Women's Health and Gender Biology


Wilson J (1), Fida D (1), Wiley A (1), Maurer R (2), Spagnolo PA (1,3) 1: Department of Psychiatry & Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA 2: Harvard Catalyst 3: Harvard Medical School

Principal Investigator


The Influence of Gender on the Comorbidity between Attention Deficit-Hyperactivity Disorder (ADHD) and Posttraumatic Stress Disorder (PTSD)


Attention Deficit-Hyperactivity Disorder (ADHD) and Posttraumatic Stress Disorder (PTSD) are often comorbid and share common neurobiological substrates. However, the prevalence of each disorder varies by gender: men are more often diagnosed with ADHD than women, while women are twice as likely as men to develop PTSD. Both race and age also have distinct influences on the prevalence of these disorders. Here, we conducted a systematic literature review and meta-analysis to investigate the influence of gender, age, and race on the prevalence of co-occurring PTSD and ADHD.

A scoping review of PsycINFO and PubMed yielded 10 eligible studies with complete outcome data. We ran fixed-effects meta-analyses of the sex-stratified prevalence of ADHD/PTSD using pooled odds ratios (OR) with 95% confidence interval (CI). Fixed-effects subgroup analyses were performed using age as a subgroup. Effect size heterogeneity was assessed using the I2 index and Cochran’s Q test.

In the whole sample (N= 12,139; F= 6188, M= 5951), the diagnosis of ADHD/PTSD was significantly higher in women than men (OR= 1.46, p < .01). When stratified by the age of the enrolled sample (minors vs adults), two distinct patterns emerged: comorbid ADHD/PTSD was more often diagnosed in boys compared to girls (OR = 0.81), while the opposite trend was observed in adults, with women exhibiting greater comorbidity rates than men (OR = 1.69, p = .03). Within the two studies reporting race/ethnicity data (N=762), non-white individuals were more likely to be diagnosed with PTSD/ADHD than white individuals (OR = 2.38, p = 0.05). Between-study heterogeneity was low-to-moderate and not significant (I2 = 40%; p=.09), validating the fixed-effects model (Figure 3). Our main finding indicates an age-related association between gender and ADHD/PTSD, which may have important mechanistic and clinical implications. Future studies should investigate the intersection between sex, race, and age in driving ADHD/PTSD comorbidity.

Research Context

Epidemiological data indicates that PTSD is a female-predominant condition, whereas ADHD is more prevalent in males than in females. However, these two conditions are highly comorbid, suggesting that they share overlapping neurobiological substrates. The present study is the first to investigate the effect of gender on ADHD/PTSD comorbidity rates using a large cohort. We found that females are more likely than males to be diagnosed with comorbid ADHD and PTSD. These findings provide further evidence of the strong link between ADHD and PTSD and point to a key role of gender in influencing such association. Furthermore, our results may have important clinical implications since they suggest that females are at increased risk of developing both conditions.