Broughton Thomas, Lambert Ellen, Wertz Jasmin, Agnew-Blais Jessica
Department of Psychology, School of Biological and Behavioural Sciences, Queen Mary University, UK.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
Br J Psychiatry. 2025 Jun 18:1-8. doi: 10.1192/bjp.2025.104.
Due to historical under-recognition of attention-deficit hyperactivity disorder (ADHD) among girls and women, little is known about female-specific factors that may affect individuals with ADHD, including those related to changes in ovarian hormones (e.g. across the menstrual cycle).
We investigated whether females with a self-reported clinical diagnosis of ADHD are more likely to experience premenstrual dysphoric disorder (PMDD). We also examined associations between PMDD and ADHD defined by a symptom and impairment threshold.
Participants were aged between 18 and 34 years, were assigned female at birth and were recruited via Prolific.com ( = 715). Participants self-reported clinician diagnosis of ADHD, depression and anxiety. ADHD symptoms were assessed via the Adult ADHD Self-Report Scale (ASRS), to which we applied a DSM-5-based symptom and impairment cut-off ('ASRS-based ADHD'). PMDD symptoms were assessed via the Premenstrual Symptoms Screening Tool (PSST), which identifies provisional PMDD. Using Poisson regression models, we compared risk for provisional PMDD among females with ADHD (self-reported clinical diagnosis [ = 102] or ASRS-based [ = 229]) with a non-ADHD reference group ( = 305). We additionally compared risk for provisional PMDD among individuals with ADHD and depression/anxiety diagnoses, ADHD only and a non-ADHD reference group.
The prevalence of provisional PMDD was elevated among individuals with a self-reported clinical ADHD diagnosis (31.4%), and among participants with ASRS-based ADHD (41.1%), compared with the non-ADHD reference group (9.8%). Individuals with ASRS-based ADHD and depression and/or anxiety diagnoses were at highest risk for provisional PMDD (relative risk 4.53 [3.10, 6.61]) compared with the non-ADHD reference group.
Clinicians should be aware that individuals with a diagnosis of ADHD, or with high ADHD symptom levels, and who have a menstrual cycle may be more likely to experience PMDD. Future research should investigate the underlying mechanisms that link ADHD and disorders associated with hormonal sensitivity, such as PMDD.
由于历史上对女孩和女性注意力缺陷多动障碍（ADHD）的认识不足，对于可能影响ADHD患者的女性特定因素知之甚少，包括与卵巢激素变化相关的因素（例如在整个月经周期中）。
我们调查了自我报告临床诊断为ADHD的女性是否更有可能经历经前烦躁障碍（PMDD）。我们还研究了PMDD与由症状和损害阈值定义的ADHD之间的关联。
参与者年龄在18至34岁之间，出生时被指定为女性，通过Prolific.com招募（n = 715）。参与者自我报告临床医生对ADHD、抑郁症和焦虑症的诊断。通过成人ADHD自我报告量表（ASRS）评估ADHD症状，我们应用基于DSM-5的症状和损害临界值（“基于ASRS的ADHD”）。通过经前症状筛查工具（PSST）评估PMDD症状，该工具可识别临时PMDD。使用泊松回归模型，我们比较了患有ADHD的女性（自我报告临床诊断[n = 102]或基于ASRS的[n = 229]）与非ADHD参考组（n = 305）中临时PMDD的风险。我们还比较了患有ADHD和抑郁症/焦虑症诊断、仅患有ADHD的个体以及非ADHD参考组中临时PMDD的风险。
与非ADHD参考组（9.8%）相比，自我报告临床ADHD诊断的个体（31.4%）和基于ASRS的ADHD参与者（41.1%）中临时PMDD的患病率升高。与非ADHD参考组相比，基于ASRS的ADHD以及患有抑郁症和/或焦虑症诊断的个体患临时PMDD的风险最高（相对风险4.53 [3.10, 6.61]）。
临床医生应意识到，诊断为ADHD或ADHD症状水平高且有月经周期的个体可能更有可能经历PMDD。未来的研究应调查将ADHD与激素敏感性相关疾病（如PMDD）联系起来的潜在机制。
