Male subjects are cited almost exclusively in the scientific literature on attention deficit hyperactivity disorder (ADHD). Females are almost surely underidentified and under treated.

This report looked at 140 girls with ADHD and compared them with controls. Both groups were appraised with diagnostic interviews, psychometric tests and academic achievement tests. Social function was also evaluated through standardized assessments of interpersonal, school and family functioning with double blind procedures.

Girls with ADHD (compared with female controls) were more likely to have conduct, mood, and anxiety disorders, lower IQ and achievement scores, and more impairment on measures of social, school and family functioning. Among the girls with ADHD, a preponderance of symptoms of inattention was found compared with the proportion with hyperactivity and impulsivity.

Clinicians should be aware that, despite their lower rates of disruptive disorders, ADHD in girls is a serious disorder associated with impairment in multiple domains of functioning. Thus, there is no reason to assume that the treatment of girls with ADHD should be any less aggressive that that of boys with ADHD. Despite this recommendation, the authors stress that clinicians should be aware that comorbidity with mood and anxiety disorders has been associated with a more complicated course of ADHD and a lack of therapeutic response to stimulant drugs.

(Biederman J et al. Attention Deficit Hyperactivity Disorder in girls. Psychiatry 38:966-978).

COMMENT: To improve the recognition and treatment of ADHD in girls, we need to do a better job of teaching teachers to focus on distractibility/inattention rather than solely on disruptive behavior. - R.A.

 

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