OBJECTIVE To investigate sex differences in associations between attention-deficit/hyperactivity disorder (ADHD) and a spectrum of comorbid disorders. METHOD The study population included all children born in Denmark from 1981 through 2013 (N = 1,665,729). Data were merged from Danish registers and information was obtained on birth characteristics, socioeconomic status, familial psychiatric history, and diagnoses of ADHD (n = 32,308) and comorbid disorders. To estimate absolute and relative risks of comorbid disorders, incidence rates and adjusted hazard ratios (HRs) with 95% CIs were calculated for female and male individuals. In addition, interactions between ADHD and sex in association with comorbid disorders were estimated as HR ratios (HRRs) in female and male individuals (95% CIs). RESULTS Individuals diagnosed with ADHD had significantly increased absolute and relative risks of all 12 comorbid psychiatric disorders investigated. ADHD-sex interactions were found for some comorbid disorders. Compared with male individuals, ADHD in female individuals showed a stronger association with autism spectrum disorder (HRR 1.86, 95% CI 1.62-2.14), oppositional defiant/conduct disorder (HRR 1.97, 95% CI 1.68-2.30), intellectual disability (HRR 1.79, 95% CI 1.54-2.09), personality disorders (HRR 1.23, 95% CI 1.06-1.43), schizophrenia (HRR 1.21, 95% CI 1.02-1.43), substance use disorders (HRR 1.21, 95% CI 1.07-1.38), and suicidal behavior (1.28, 95% CI 1.12-1.47). The remaining disorders showed no significant sex differences in association with ADHD. CONCLUSION This study indicates that the association between ADHD and several comorbid disorders is stronger in female than in male individuals. These important findings add to the literature on sex differences in ADHD and suggest that female individuals diagnosed with ADHD are a more vulnerable group of patients.

中文翻译：

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注意缺陷/多动障碍的合并症模式中的性别差异。

目的研究注意缺陷/多动障碍（ADHD）和一系列合并症之间的性别差异。方法研究人群包括1981年至2013年在丹麦出生的所有儿童（N = 1,665,729）。数据从丹麦登记处合并，并获得了有关出生特征，社会经济状况，家族精神病史以及ADHD（n = 32,308）和合并症的诊断信息。为了估计合并症的绝对和相对风险，计算了男性和女性个体的发生率和95％CI的调整后的危险比（HRs）。此外，多动症和性别与合并症之间的相互作用被估计为女性和男性个体的心律比（HRR）（95％CI）。结果被诊断患有多动症的个体在接受调查的所有12种合并精神病患者中的绝对和相对风险均显着增加。发现ADHD-性相互作用为某些合并症。与男性相比，女性多动症与自闭症谱系障碍（HRR 1.86，95％CI 1.62-2.14），对立违抗/品行障碍（HRR 1.97，95％CI 1.68-2.30），智力障碍（HRR）之间的关联更强1.79，95％CI 1.54-2.09），人格障碍（HRR 1.23，95％CI 1.06-1.43），精神分裂症（HRR 1.21，95％CI 1.02-1.43），物质使用障碍（HRR 1.21，95％CI 1.07-1.38） ）和自杀行为（1.28，95％CI 1.12-1.47）。其余的疾病与ADHD无明显的性别差异。结论本研究表明，女性多动症与几种合并症之间的关联性强于男性。这些重要发现为有关多动症中性别差异的文献增色，并表明诊断为多动症的女性个体是较脆弱的患者群体。