For decades, attention deficit hyperactivity disorder (ADHD) has largely been viewed through the lens of disruptive behaviour in boys. Yet many girls with the condition often go unnoticed because their symptoms may appear quieter, internalised, or masked by what experts sometimes describe as "good girl" behaviour, being compliant, hardworking, and eager to avoid drawing attention to themselves. Now, a major new study published in Nature Mental Health suggests that the consequences of missed or delayed ADHD recognition in girls may extend far beyond childhood.

Researchers from the University of Glasgow found that women diagnosed with ADHD during childhood, particularly those from socioeconomically deprived backgrounds, were significantly more likely to develop multiple chronic health conditions by early adulthood.

The study analysed health records from more than 120,000 women aged 18 to 32 years and found that the combined effects of ADHD and socioeconomic disadvantage substantially increased the likelihood of multimorbidity, a term used to describe the presence of two or more long-term physical or mental health conditions. The findings add to growing evidence that ADHD is not merely a childhood behavioural disorder but a lifelong neurodevelopmental condition with important implications for physical and mental health.

ADHD In Girls: A Frequently Missed Diagnosis

According to the UK National Institute for Health and Care Excellence (NICE), ADHD affects approximately 3% to 4% of adults and is characterised by persistent patterns of inattention, impulsivity, and hyperactivity. However, symptoms often present differently in girls than in boys, making diagnosis more challenging.

Research published by the UK Royal College of Psychiatrists notes that girls are more likely to experience inattentive symptoms such as daydreaming, forgetfulness, emotional dysregulation, and low self-esteem rather than overt hyperactivity. As a result, many girls are diagnosed later in life or remain undiagnosed altogether.

This phenomenon has led experts to warn that societal expectations encouraging girls to be compliant, organised, and emotionally controlled may inadvertently conceal underlying ADHD symptoms, delaying access to treatment and support.

What The New Study Found

The Glasgow-led study examined linked healthcare records and socioeconomic data from 120,000 women between the ages of 18 and 32 years. Researchers investigated how childhood ADHD and socioeconomic deprivation influenced the development of multimorbidity in adulthood.

The findings were striking.

Women who had both a childhood ADHD diagnosis and a history of socioeconomic deprivation were more than twice as likely to experience multimorbidity compared with women who did not have ADHD.

Researchers also identified distinct patterns of disease clustering. Women with ADHD were significantly more likely to belong to a severe category termed pan-system multimorbidity, characterised by multiple physical illnesses alongside complex mental health conditions.

This cluster frequently included:

  • Post-traumatic stress disorder (PTSD)
  • Borderline personality disorder
  • Anxiety disorders
  • Depression
  • Chronic physical health conditions

By contrast, women without ADHD were more likely to experience disease patterns dominated by physical health conditions alone. The study suggests that ADHD may contribute to lifelong vulnerabilities that extend beyond cognition and behaviour, influencing mental health, healthcare access, social outcomes, and overall disease burden.

Why Socioeconomic Deprivation Matters

The research highlights the powerful interaction between health and social disadvantage. According to the World Health Organization (WHO), social determinants such as income, education, housing, employment, and access to healthcare play a crucial role in shaping health outcomes throughout life.

Children growing up in deprived environments often face higher levels of chronic stress, reduced access to healthcare services, poorer nutrition, and increased exposure to adverse childhood experiences. Previous research has shown that these factors independently increase the risk of both mental and physical illness. The new study suggests that when ADHD is combined with socioeconomic disadvantage, the effects may compound each other, creating a pathway toward poorer long-term health.

Lead author Dr Naomi Wilson from the University of Glasgow said the findings indicate that girls with ADHD from disadvantaged backgrounds should be considered a high-risk group requiring earlier and more integrated support.

The Link Between ADHD And Physical Health

While ADHD is primarily classified as a neurodevelopmental disorder, increasing evidence suggests it is associated with a wide range of physical health conditions. Research published in The Lancet Psychiatry has linked ADHD with elevated risks of obesity, sleep disorders, substance use disorders, cardiovascular disease, and poorer overall health outcomes.

A large Swedish population study involving more than four million individuals found that ADHD was associated with an increased risk of numerous physical conditions, including nervous system disorders, respiratory diseases, musculoskeletal conditions, and metabolic illnesses. Experts believe several mechanisms may contribute to these associations, including chronic stress, sleep disruption, difficulties maintaining healthy lifestyles, and barriers to accessing healthcare.

Why Early Diagnosis Matters

The study's authors argue that earlier identification of ADHD in girls could help reduce long-term health risks. Evidence suggests that timely diagnosis and appropriate interventions, including behavioural therapy, educational support, mental health care, and medication when indicated, can improve academic achievement, emotional wellbeing, social functioning, and quality of life.

The findings also reinforce calls for healthcare systems to adopt a more holistic approach to ADHD care, recognising that the condition may affect multiple aspects of health throughout adulthood.

The University of Glasgow study provides compelling evidence that childhood ADHD and socioeconomic disadvantage can have lasting effects on women's health. Women with both risk factors were more than twice as likely to develop multiple long-term health conditions by early adulthood, highlighting the need for earlier diagnosis and targeted support. As awareness grows around the unique ways ADHD presents in girls, experts say improving recognition and access to care could play a critical role in reducing future health inequalities and improving lifelong outcomes.



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