ADHD: Women are diagnosed five years later than men, despite symptoms appearing at the same age.

European College of Neuropsychopharmacology

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Scientists have found that ADHD (Attention-Deficit/Hyperactivity Disorder) in women is diagnosed approximately 5 years later than in men, despite symptoms appearing at the same age. Women with ADHD also suffer greater emotional and functional difficulties than men. This work will be presented at the ECNP Congress in Amsterdam, after recent publication.

Lead researcher Dr Silvia Amoretti (Barcelona) said:

“ADHD affects millions of people, but our understanding of how it presents and impacts males and females differently remains limited. We found that females are underdiagnosed, often receiving a diagnosis years later than males. This delay may lead to worse clinical outcomes, including depression, anxiety, and functional impairment. Males on the other hand showed a higher level of involvement in delinquent behaviours such as legal problems and driving-related difficulties. We believe that a better understanding these sex-based differences might improve diagnosis and treatment.”

The researchers analysed a large clinical sample of 900 adults (54.9% male, 45.1% female, average age 36.94) diagnosed with ADHD for the first time at a specialized outpatient program in Barcelona. They assessed differences between males and females in terms of age at diagnosis, ADHD symptom severity, psychiatric comorbidities, psychosocial functioning, and disability. Participants underwent a standardized battery of clinical interviews and validated rating scales. They found that females had been diagnosed with ADHD at an average age of 28.96 years, whereas males were diagnosed at age 24.13 on average. Symptoms appeared in both males and females at approximately the same age. Males were around 3 times more likely to have encountered legal problems (18.1%) than were females (6.6%).

Silvia Amoretti said:

“We found that although ADHD symptoms started at a similar age in males and females, women were diagnosed about five years later. By the time of diagnosis, they showed more severe symptoms, worse functioning in daily life, and higher rates of depression and anxiety.

This is important because it shows that ADHD often goes unnoticed in women until it becomes a serious problem. Our findings suggest that we may be missing the early signs in girls and women, especially when their symptoms are less disruptive but still impactful. This has clear implications for earlier screening and sex-sensitive diagnostic tools.

We didn’t set out to compare the age of diagnosis in males and females, we were aiming to understand the general age when symptoms appear, regardless of sex. This finding was not part of our initial hypotheses but became evident during the analysis but became evident during the analysis, and the scale of the difference in diagnosis between the sexes was a surprise.

It’s likely that women are diagnosed later because the symptoms of ADHD manifest themselves differently in men and women. Boys are more likely to be hyperactive or impulsive, and this behaviour is more visible to parents, teachers and clinicians. On the other hand, girls with ADHD are more likely to seem inattentive and generally less disruptive. This becomes clinically important, as it means that women are just not treated early enough, and often are just not diagnosed at all. We have seen similar tendencies internationally, so it is likely that this is a global problem. The nature of the condition leads to poorer diagnosis in women everywhere, meaning that women can lose on average five years of treatment, 5 years of a better life”.

Commenting, Professor Sandra Kooij (Amsterdam UMC/VUmc and PsyQ, the Hague, the Netherlands) said:

“This study by Sylvia Amoretti and colleagues shows the delay in diagnosis in girls and women with ADHD compared to boys and males. Different presentation of symptoms, lack of awareness among clinicians that women have ADHD too, and the hormonal changes leading to severe mood instability in the last week of the cycle are all responsible for the gender differences in time to diagnosis of ADHD. 

Increasing awareness in both society and medicine helps girls and women to get earlier help when they need it”. 

Professor Kooij was not involved in this research; this is an independent comment. Professor Kooij is founder and chair of the European Network Adult ADHD.

The work on which this is based was published in European Psychiatry, doi: 10.1192/j.eurpsy.2025.2441. None of the comments in this press release are included in the publication.  Please acknowledge the presentation at the ECNP congress in any press release.

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Journal

European Psychiatry

DOI

10.1192/j.eurpsy.2025.2441 

Method of Research

Observational study

Subject of Research

People

Article Title

Sex differences in adults with attention-deficit/hyperactivity disorder: A population-based study

 

Does the change in food consumption patterns affect the level of dietary zinc intake?

Higher Education Press

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Credit: Lu LIU 1, 2, Alida MELSE-BOONSTRA 3, Wen-Feng CONG 1, † , Mo LI 1, Fusuo ZHANG 1, Wopke VAN DER WERF 2, Tjeerd JAN STOMPH 2

Zinc is an essential trace element for the human body, participating in the synthesis and activation of over 300 enzymes, and is crucial for growth and development, immune function, and neurobehavioral regulation. However, zinc deficiency remains one of the major “hidden hunger” issues worldwide. With the rapid economic development and dietary structure transformation in China, significant changes have occurred in residents’ food consumption patterns. Has this affected the level of dietary zinc intake?

Recently, a research team led by Professor Wenfeng Cong from China Agricultural University, in collaboration with Dr. Wopke van der Werf from Wageningen University & Research in the Netherlands, revealed the changing trends of dietary zinc intake among Chinese adults and the underlying reasons by analyzing data from China Health and Nutrition Surveys conducted between 2004 and 2011. The study covered 21,266 adults aged 18–50 from 9 provinces and 3 municipalities directly under the central government in China. The results showed that from 2004 to 2011, the average daily zinc intake of Chinese adults decreased from 11.1 to 9.89 mg, and the proportion of people with insufficient intake increased from 23% to 37%, a growth of more than 60%. Notably, this trend was prevalent across different income groups—although the zinc intake of high-income groups was consistently higher than that of low-income groups, zinc intake in all income strata showed a downward trend. The related paper has been published in Frontiers of Agricultural Science and Engineering (DOI: 10.15302/J-FASE-2024584).

The study found that the reduction in grain consumption was the primary reason for the decline in zinc intake. Data showed that the zinc obtained by adults from grains decreased from 6.27 mg·d–1 in 2004 to 4.68 mg·d–1 in 2011, and its proportion in total zinc intake dropped from 58% to 48%. Although the consumption of zinc-rich foods such as meat increased, it only partially offset the impact of reduced grain consumption. For example, the zinc provided by meat slightly increased from 1.78 to 1.85 mg·d–1, with its proportion rising from 15% to 17%.

From the perspective of regional differences, the rates of insufficient zinc intake varied significantly among provinces. The problem in Henan Province was particularly prominent, with the zinc intake insufficiency rate reaching as high as 65% in 2011, an increase of 28 percentage points compared to 2004; while in the Guangxi Zhuang Autonomous Region, the insufficiency rate remained at a low level of 18%–19% during the same period. No significant differences were found between urban and rural areas, but the average daily zinc intake of men was generally higher than that of women.

The researchers pointed out that this change is closely related to the transformation of China’s dietary structure. Over the past few decades, the consumption of animal protein by Chinese residents has increased significantly, but the status of grains as a traditional staple food has declined, leading to a reduction in the main food source of zinc. In addition, although high-income groups can supplement their intake by purchasing more zinc-rich foods such as meat and nuts, the overall change in dietary patterns has still resulted in a decrease in total zinc intake.

This study systematically analyzed the association between dietary zinc intake and socioeconomic factors, as well as regional dietary patterns. It emphasized that addressing the problem of insufficient zinc intake requires formulating strategies based on regional dietary characteristics, such as promoting foods with higher zinc density or improving the zinc content of crops through biofortification technology. Approximately 40% of China’s soil has zinc deficiency problems, and targeted agricultural interventions may become an important way to improve residents’ zinc nutritional status.

Currently, the zinc deficiency rate among children and adolescents in China is still as high as 27%, while the problem of insufficient zinc intake among adults shows signs of improvement, but with significant regional differences. In the future, more attention should be paid to the dietary quality of low-income groups, and at the same time, through nutrition education and agricultural technological innovation, promote the transformation of residents’ diets to a “zinc-friendly” model.

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Journal

Frontiers of Agricultural Science and Engineering

DOI

10.15302/J-FASE-2024584 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Time trends in dietary Zn intake and occurrence of dietary Zn inadequacy among Chinese adults: data from the China Health and Nutrition Surveys between 2004 and 2011

 

Transnational electoral participation of undocumented Mexican immigrants in the US

New study investigates the engagement of undocumented Mexican immigrants in the US in external voting in Mexican elections

Waseda University

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This study explores the political participation of undocumented Mexican immigrants in the US regarding their involvement in external voting in Mexico. The study employs respondent-driven sampling to address the challenges of studying this hard-to-reach population. It finds that lack of electoral information, lower education levels, and distrust in the Mexican government correlate with reduced electoral participation.  

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Credit: Associate Professor Yuriko Takahashi from Waseda University, Japan

The global increase in migration—with approximately 3.6% of the global population living as expatriates—has resulted in many countries extending external voting rights to their overseas citizens. This has prompted scholarly interest in understanding the electoral participation of immigrants in their countries of origin. However, most research has focused on the factors that drive the provision of external voting rights to expatriates rather than the extent to which these rights are exercised. Furthermore, prior research has largely overlooked the political behavior of undocumented immigrants, who constitute a significant share of the immigrant population, especially in the United States (US). Conventional research, using traditional survey methods, does not adequately include undocumented immigrants, resulting in biased findings.

To address these shortcomings, a team of researchers led by Associate Professor Yuriko Takahashi of Waseda University employed a novel methodology based on respondent-driven sampling (RDS) to conduct a large-scale survey in Illinois to assess the engagement of undocumented Mexicans living in the US with Mexico’s overseas voting system. “Our RDS-based survey provides a unique opportunity to gain insights into the political attitudes of undocumented immigrants by enabling the creation of a representative sample of this hard-to-reach population without a sampling frame. This approach, therefore, leads to the generation of unbiased results,” explains Takahashi. The results of this novel study, which included Associate Professor Jaehyun Song, Kansai University, and Professor Takeshi Iida, Doshisha University, were published on 05 September 2025 in The Journal of Race, Ethnicity, and Politics.

In the first stage, the researchers conducted personal interviews with the leaders of Mexican immigrant communities residing in major cities in the US between 2020 and 2021, followed by focus groups in Chicago and Los Angeles in 2022. Based on the findings of this initial research, they designed the RDS survey and conducted it in urban and rural areas of Illinois in 2023, with a total of 502 respondents. Four major factors influenced the study population’s political participation in transnational elections, including their source of electoral information, level of education, level of trust in the Mexican government, and sense of political efficacy.

Adequate electoral information from public organizations significantly increased the likelihood of obtaining voter credentials and casting a vote. However, those receiving the information from family members or mass media were less likely to register and vote. Similarly, higher education levels correlated with increased registration and voting, with the opposite in those with lower education levels. Trust in the Mexican government also positively impacted political engagement only at the stage of obtaining voter credentials, while trust in the US government positively influenced external electoral participation. On the other hand, while external political efficacy correlated with greater interest in obtaining voter credentials, it was also associated with less active voter registration and voting.

These findings suggest that a lack of electoral information from public organizations, lower levels of education, greater distrust of the Mexican government, and the perception that a single vote will not influence the electoral outcome led to less active overseas political engagement. This also demonstrates the value of RDS as a systematic approach to examining the political perceptions and participation of hard-to-reach populations, such as undocumented immigrants.

“Our findings provide important insights for countries with large emigrant populations, such as Mexico, where overseas voting rights are expanding. By showing how expatriates influence their home country through political participation, the study informs policies that can strengthen electoral engagement abroad. More broadly, it underscores the growing political significance of immigrants in shaping the societies of both sending and receiving countries,” concludes Takahashi.

 

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Reference
DOI: 10.1017/rep.2025.10018

 

Authors: Yuriko Takahashi1, Jaehyun Song2, and Takeshi Iida3

 

Affiliations

1Waseda University, Japan 

2Kansai University, Japan

3Doshisha University, Japan

 

About Waseda University
Located in the heart of Tokyo, Waseda University is a leading private research university that has long been dedicated to academic excellence, innovative research, and civic engagement at both the local and global levels since 1882. The University has produced many changemakers in its history, including eight prime ministers and many leaders in business, science and technology, literature, sports, and film. Waseda has strong collaborations with overseas research institutions and is committed to advancing cutting-edge research and developing leaders who can contribute to the resolution of complex, global social issues. The University has set a target of achieving a zero-carbon campus by 2032, in line with the Sustainable Development Goals (SDGs) adopted by the United Nations in 2015. 

To learn more about Waseda University, visit https://www.waseda.jp/top/en  

 

About Associate Professor Yuriko Takahashi
Dr. Yuriko Takahashi has been an Associate Professor at Faculty of Political Science and Economics, Waseda University, since 2016. Her research explores political attitudes and behavior of migrants and Latinx individuals in the US and Latin America, alongside the political economy of immigration, using quantitative methods. She previously worked at the Embassy of Japan in Mexico (1994–1996), served as Associate Professor at Kobe University’s Graduate School of International Cooperation Studies (2006–2016), and was a Visiting Scholar at the Center for US-Mexican Studies, University of California, San Diego (2021–2023). Her work bridges migration, political science, and international cooperation.

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Journal

The Journal of Race Ethnicity and Politics

DOI

10.1017/rep.2025.10018 

Method of Research

Survey

Subject of Research

People

Article Title

Transnational Political Participation of Undocumented Mexican Immigrants in the US: Respondent-Driven Sampling with the Hard-to-Reach Population

Article Publication Date

5-Sep-2025

 

Eating grasshoppers: a delicacy for foodies, dinner for Oaxacans

A new book discusses the changing meaning of chapulines in Mexico

Ohio State University

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Eating toasted grasshoppers in parts of Mexico, a food once derided as only for poor people, is now celebrated as a delicacy by visiting tourists from the United States and elsewhere.

 

The change in perception of chapulines (from the Nahuatl term chapolin) shows how food and its meaning change through time, said Jeffrey H. Cohen, author of the new book “Eating Grasshoppers: Chapulines and the Women Who Sell Them.”

 

In the book, Cohen, a professor of anthropology at The Ohio State University, explores chapulines and their role in culture, tradition and the survival of the Mexican people.

 

Cohen has spent years doing research in the southern Mexican state of Oaxaca, where chapulines are a seasonal treat that appears with the start of the rainy season in May.

 

“For tourists, grasshoppers are seen as a delicacy, or a novelty.  But for the local residents, it is just food,” Cohen said.

 

“It has been a part of meals for thousands of years.”

 

They are easy to prepare. The grasshoppers are dipped in boiling water, which turn them a deep red color. They are then placed on a cooking surface with garlic, lemon, chili and other seasonings and are ready to eat in a few minutes.

 

Grasshoppers have been a major source of protein for the local populations for centuries, but their status changed after the Spanish conquest, when new foods were introduced to the region.

 

“The Spanish thought of eating grasshoppers (saltamontes in Spanish) as absurd – not as something you would actually eat,” Cohen said.

 

Still, Oaxacans continued to enjoy their chapulines.

 

And then in the 1920s and ’30s, the Mexican government pushed a new food agenda, in which officials encouraged locals to eat what they considered “more modern nutritional foods,” by replacing local favorites like tortillas with bread and chapulines with other kinds of protein, such as beef and pork.

 

While many Mexicans did incorporate other foods in their meals, eating grasshoppers never disappeared from the menu. They were readily available in the fields around their homes and less expensive than other food choices.

 

And collecting, preparing and selling chapulines was an important and often vital job for many women.

 

“The women who sell grasshoppers in local markets have become important breadwinners for their families, earning incomes that can exceed professionals in the cities,” Cohen said.

 

During COVID-19, when markets closed down, chapulineras – the women who sell chapulines – found innovative ways to sell their grasshoppers. They created a touchless economy using WhatsApp and other messaging services to connect to customers, leaving purchased products outside their houses for pickup.  Some also provided no-interest loans to people who could not afford their orders.

 

The meaning and value of chapulines has changed again recently, as Oaxaca has become a popular tourist destination.

 

“For many foodies and other tourists, tasting chapulines becomes a way to experience the past, to feel they are connected to a long exotic history,” Cohen said.

 

Chapulineras have learned to cater to these tourists.

 

“These women know how to play to the foodies. They talk about the 3,000-year tradition and how it goes back to their ancestors who lived there,” Cohen explained.

 

“And they also use more modern pitches. They emphasize nutrition and their high protein content. It really connects to the tourists.”

 

As much as the women try to appeal to tourists, they also know that it is not how they make their living. The market is based on feeding the local residents, and not foodies who stop by for a taste of the past.

 

“The way the women described it to me was that if a tourist comes by and buys a bag of grasshoppers, that’s great, but they are leaving, never to be seen again,” he said.

 

“What I need to do is sell grasshoppers by the kilo to the people who live here, and if I don’t do that, I’m not going to make enough money.”

 

Cohen said as much as the culture and meaning around chapulines have changed over the centuries, their appeal has endured – and that is unlikely to change.

 

“It still amazes me how much chapulines remain a part of everyday life in Oaxaca and how incredibly important they are to the economy and to the culture of the area,” he said.