Adult ADHD in women misdiagnosed as depression: Diagnostic challenges, clinical consequences and implications for healthcare education – a narrative review

Background. Attention-deficit/hyperactivity disorder (ADHD) in adult women remains substantially underdiagnosed and frequently misinterpreted as depressive disorders. This diagnostic inaccuracy is associated with gender-specific symptom presentation, internalization of difficulties, and compensatory masking strategies. Aim. The aim of this narrative review is to examine the mechanisms underlying the misdiagnosis of ADHD as depression in adult women, identify key diagnostic challenges, evaluate clinical consequences, and discuss implications for healthcare education. Material and methods. A narrative review of 30 peer-reviewed articles published between 2009 and 2026 was conducted. Databases including PubMed and Google Scholar were searched using keywords related to adult ADHD, women, depression, and misdiagnosis. Results. Evidence indicates that adult women with ADHD are frequently misdiagnosed with depressive disorders due to overlapping symptoms such as fatigue, impaired concentration, and emotional dysregulation. Gender-specific factors, including social expectations and masking behaviors, significantly delay diagnosis. Misdiagnosis results in inappropriate pharmacological treatment, chronic functional impairment, and increased psychiatric comorbidity. Conclusions. ADHD in women requires a gender-sensitive diagnostic approach. Increased clinician awareness and improved training in differential diagnosis are essential to reduce misdiagnosis and improve patient outcomes.