Demographic and Psychosocial Correlates of Adult ADHD Subtypes in Rural Canada: A Gender-Based Analysis

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) frequently persists into adulthood and is characterized by heterogeneous clinical presentations influenced by gender, demographic and psychosocial factors. Although gender-related differences in adult ADHD have been reported, individuals residing in rural settings remain underrepresented in empirical research. Guided by Gender-Based Analysis Plus (GBA+) framework, this study examined gender differences and psychosocial correlates of ADHD subtypes among adults in a rural Canadian population. Methods: A cross-sectional study was conducted using de-identified medical record data collected between February 2021 and January 2024 from a rural outpatient clinic in Northern British Columbia, Canada. The sample comprised 660 adults aged 19 years and older with a documented ADHD diagnosis. The combined presentation was the most common (67.0%), followed by the inattentive presentation (30.3%), while the hyperactive/impulsive presentation was rare (2.7%). In bivariate analyses, ADHD presentation was not significantly associated with gender, age group, employment status, or marital status. Prescribed ADHD medication differed across presentations (χ2 (1) = 12.36, p < 0.001), with a higher proportion of individuals with the inattentive presentation reporting pharmacological treatment. In the pooled logistic regression model, prescribed ADHD medication was the only variable independently associated with presentation (OR = 0.54, 95% CI 0.38–0.77, p = 0.001). In gender-stratified models, this association remained evident among women, whereas no stable inferential conclusions could be drawn for men or gender-diverse participants. Conclusions: Within a GBA+ perspective, the findings suggest that gender may shape recognition and entry into care, rather than the clinical subtype identified at assessment, underscoring the need for a comprehensive assessment in rural clinical practice.