Abstract
Objective: The goal of this study was to examine the prevalence of postpartum distress among women with attention deficit/hyperactivity disorder (ADHD).
Methods: Using a large electronic health records registry, a sample of 13,588 women with and 474,789 women without ADHD (18–45 years old) who had birth delivery records between 2010 and 2022 was identified. The prevalence of distress, including depression, anxiety, obsessive-compulsive disorder (OCD), and stress-related disorders at 6 weeks and 12 months following delivery, was compared between groups. Analyses also considered the effects of other factors associated with postpartum distress, including age, race, and ethnicity, as well as preexisting physical and mental health concerns.
Results: Relative to women without ADHD, women with ADHD reported higher rates of depression, OCD, and stress-related disorders at 6 weeks and 12 months following delivery. Compared to women without ADHD, and considering the effects of race, ethnicity, age, and preexisting mental and physical health conditions, women with ADHD were 1.14 times more likely to be diagnosed with mood disorder at 6 weeks postpartum and 1.21–1.24 times more likely to be diagnosed with a mood, anxiety, or stress-related disorder at 12 months postpartum.
Conclusion: Women with ADHD face adversity in the acute and long-term postpartum periods. Future research examining mechanisms of postpartum risk and resilience is needed to guide the development of treatments to support women with ADHD during this sensitive developmental period.
J Clin Psychiatry 2025;86(3):24m15724
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