Understanding Barriers to Adult ADHD Diagnosis: A Scoping Review
TL;DR
Future research is needed to better capture adult- and gender-specific ADHD symptoms and domains of impairment to help refine diagnostic criteria and processes, enhance provider education, and support more timely and equitable access to care.
Abstract
Aim: This review examined the barriers that delay the diagnosis of ADHD in adult populations. Background: Although ADHD is increasingly recognized as a condition that persists beyond childhood, many adults remain undiagnosed. Adults often face challenges in obtaining a diagnosis, yet research on the barriers to timely identification remains limited. Undiagnosed ADHD is associated with adverse health outcomes, functional impairments, and economic burden. Primary care providers (e.g. family physicians and nurse practitioners) are ideally situated to identify and diagnose ADHD across the lifespan. A clearer understanding of the barriers adults encounter during the diagnostic process is essential to inform research, education, and policy to ensure equitable, high-quality care. Methods: Five electronic databases were searched to identify peer-reviewed studies, published in English within the past five years, that explored barriers to timely adult ADHD diagnosis. The results were imported into Covidence for screening, and nineteen articles met the criteria for data extraction. Findings: Thematic analysis revealed five overarching themes: (1) comorbid mental health disorders, (2) diagnostic criteria, (3) diagnostic processes, (4) gendered differences in presentation, and (5) provider education and training. Conclusion: Future research is needed to better capture adult- and gender-specific ADHD symptoms and domains of impairment. This will help refine diagnostic criteria and processes, enhance provider education, and support more timely and equitable access to care.