Attention-Deficit Hyperactivity Disorder and gender

Excerpt

Attention-Deficit Hyperactivity Disorder (ADHD) is a chronic disease with onset in childhood and a worldwide prevalence around 5%, traditionally described as a disease of hyperactive and impulsive young boys. This clinical stereotype belies the fact that millions of young girls and women suffer from this disease, and are too frequently misdiagnosed, undertreated, and underrepresented in research studies. Even though several studies have described a much larger prevalence of ADHD in boys than girls, most recent analyses with community-based samples, in contrast with clinic-referred samples, have been changing this perception and confirming that ADHD in girls is quite prevalent and disabling. Boys have more overt behavioral symptoms (including more rule-breaking and externalizing behaviors) and are more likely to be referred to specialty clinics and treated for the disorder; not surprisingly, prevalence studies were influenced by this selection bias, leading to a biased underrepresentation of the prevalence of ADHD in girls, who tend to present with more inattentive than hyperactive symptoms, as well as less dramatic behavioral symptoms (Abikoff et al. 2002). Teachers and parents are less likely to bring to medical attention a girl with inattentiveness and anxiety than a boy who is oppositional, impulsive and hyperactive at home and school, for instance. …