Psychiatric comorbidity, burden of sickness absence and sex-specific characteristics of working individuals with ADHD treated in primary care in the Finnish occupational health system: cross-sectional register study

Background Previous research on attention-deficit hyperactivity disorder (ADHD) research has overlooked high-functioning workers managed in occupational health settings. Aims To investigate clinical characteristics, service use, and sex-related differences in medication and work disability among employees with ADHD. Method This study was a cross-sectional descriptive analysis of psychiatric comorbidities in 2117 patients (53.8% men, 46.2% women) with a clinical diagnosis of ADHD (ICD-10 F90.0) in the Finnish occupational health system (2018–2022). We explored service use, medication and sickness absence periods (using multinomial regression models) in a subset with available data ( n = 1447). Results Psychiatric comorbidity affected 80.5% of patients, most commonly involving anxiety disorders (51.8%) and depression (43.9%). Service use was high: 87.0% consulted a psychiatrist and 70.1% a psychologist. Medication profiles differed by sex (Cramer’s V = 0.15): men more frequently received psychostimulants only (27.4% v . 18.4%), whereas women were more likely to receive antidepressants only or antidepressant–anxiolytic combinations. Women demonstrated substantially higher levels of psychiatric sickness absence compared with men across all duration categories, with relative risk ratio (RRR) = 2.08 (95% CI 1.37–3.14) for short (1 to 7 days) absences, RRR = 2.03 (95% CI 1.42–2.90) for intermediate (8 to 30 days) absences and RRR = 2.75 (95% CI 2.16–3.52) for long-term (>30 days) absences. Conclusions Working adults with ADHD carry a heavy comorbidity burden and use specialised services extensively. Women are more frequently managed with comorbidity-focused medications rather than stimulants only and experience disproportionately higher psychiatric-related work disability. Sex-specific clinical pathways may be needed to preserve workability in this population.