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Gender differences in ADHD

The question of whether there are differences in rates and features of ADHD between males and females remains a controversial subject. The majority of evidence indicates that among children and adolescents in the general population, this condition is three times more common in boys than in girls [ref]. However, one well-designed study found that over 9% of adolescent girls in the general population meet diagnostic criteria for ADHD [ref], which is similar to the overall rate of ADHD in the general population [ref, ref].

It has been suggested that the diagnostic criteria for ADHD may be biased towards how males experience and express the condition, and that it is under-detected in females [ref]. In clinical treatment settings, boys with ADHD outnumber girls by as much as 9:1 [ref]. This suggests that regardless of any true gender differences in rates of ADHD, there is also a referral bias, where boys with ADHD are being identified and sent for treatment more frequently than girls. This is likely due to the fact that boys have higher rates of Disruptive Behavior Disorders than girls and are more often sent for treatment because of that reason, and in the process they are also diagnosed and treated more often for ADHD [ref].

In samples of adults seeking treatment for ADHD there is a more even ratio of 1.7:1 men to women [ref]. Adults usually present for treatment because they themselves recognize that they may be suffering from the symptoms of ADHD, as opposed to children and adolescents who tend to be referred by teachers or parents because of disruptive behavior. Therefore, the more even ratio of ADHD among adult men and women may reflect the true state of ADHD symptoms in the population, whereas in children and adolescents ADHD may be under-detected in females because they tend to be less disruptive than their male counterparts.

The best available evidence shows that there are few major differences in the patterns or features of ADHD between males and females, whether in terms of the subtype of ADHD symptoms or the rates of other co-occuring psychiatric conditions [ref]. Although there have been studies showing that females are more likely to suffer from the Inattentive Type of ADHD and less likely to have the Hyperactivity-Impulsivity Type than males [ref], other studies have found no significant differences here [ref].

 

Course & Prevalence

ADHD in Adulthood