Article

Attention-Deficit Hyperactivity Disorder in Girls

SUNY Upstate Medical University, Syracuse, New York 13210, USA.
CNS Drugs (Impact Factor: 4.38). 02/2006; 20(2):107-23. DOI: 10.2165/00023210-200620020-00003
Source: PubMed

ABSTRACT Attention-deficit hyperactivity disorder (ADHD) in girls is a topic of growing research and clinical interest. For many years, girls with ADHD have been ignored and overshadowed by hyperkinetic and impulsive boys, but they are now attracting interest in an effort to understand the similarities and differences in the prevalence, symptoms, familial risk, comorbidities and treatment of ADHD in the two sexes. A review of past and current literature finds that the symptoms of ADHD are not sex specific, but that identification of girls with ADHD is hampered by parental and teacher bias, and confusion. Girls are more likely to be inattentive without being hyperactive or impulsive, compared with boys. Girls and boys share the same familial risk patterns, as well as similar, although not identical, comorbidity or impairment patterns. The risk of non-treatment is as great in girls as it is in boys; up to 70-80% of identified children will have persistent symptoms and impairment that extends into adolescence and adulthood. Treatment modalities are equally effective in girls and boys. Stimulants, non-stimulants and behavioural modalities are the mainstays of effective treatment.

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    • "A.J. Porter et al. 6 hyperactive/impulsive or combined subtype, whereas females typically express the predominantly inattentive subtype (Staller and Faraone, 2006). Males with ADHD also have a higher incidence of other externalised disruptive behaviours (Rucklidge, 2010)a n da r em o r es u s c e p t i b l et od i s o r d e r so f excitability and movement, such as Tourette'ss y n d r o m eo r Parkinson'sdisease(Haaxma et al., 2007; Shulman, 2007). "
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    ABSTRACT: Mice lacking functional neurokinin-1 receptors (NK1R-/-) display behavioural abnormalities resembling attention deficit hyperactivity disorder (ADHD): locomotor hyperactivity, impulsivity and inattentiveness. The preferred ligand for NK1R, substance P, is metabolised by angiotensin converting enzyme (ACE), which forms part of the brain renin angiotensin system (BRAS). In view of evidence that the BRAS modulates locomotor activity and cognitive performance, we tested the effects of drugs that target the BRAS on these behaviours in NK1R-/- and wildtype mice. We first tested the effects of the ACE inhibitor, captopril, on locomotor activity. Because there are well-established sex differences in both ADHD and ACE activity, we compared the effects of captopril in both male and female mice. Locomotor hyperactivity was evident in male NK1R-/- mice, only, and this was abolished by treatment with captopril. By contrast, male wildtypes and females of both genotypes were unaffected by ACE inhibition. We then investigated the effects of angiotensin AT1 (losartan) and AT2 (PD 123319) receptor antagonists on the locomotor activity of male NK1R-/- and wildtype mice. Both antagonists increased the locomotor activity of NK1R-/- mice, but neither affected the wildtypes. Finally, we tested the effects of captopril on the performance of male NK1R-/- and wildtype mice in the 5-choice serial reaction-time task (5-CSRTT) and found that ACE inhibition prevented the impulsivity of NK1R-/- mice. These results indicate that certain behaviours, disrupted in ADHD, are influenced by an interaction between the BRAS and NK1R, and suggest that ACE inhibitors could provide a novel treatment for this disorder. Copyright © 2015. Published by Elsevier B.V.
    European Neuropsychopharmacology 02/2015; 32(4). DOI:10.1016/j.euroneuro.2015.01.013 · 5.40 Impact Factor
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    • "Hence, the symptoms may not be diagnosed until secondary school or when the academic work becomes more demanding (Faraone et al., 2000). For many years, girls with ADHD have been ignored and overshadowed by hyperkinetic and impulsive boys, but they are now attracting interest in an effort to understand the similarities and differences in the prevalence, symptoms, familial risk, comorbidities, and treatment of ADHD in the two sexes (Staller and Faraone, 2006). McBumett et al. (1999) argued that hyperactivity can be observed at a younger age. "
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    Asia-Pacific Psychiatry 12/2013; 6(4). DOI:10.1111/appy.12114 · 0.42 Impact Factor
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    • "With the proposed DSM-5 criteria, normal pubertal behaviors like acting without thinking, being impatient , and difficulty resisting temptations and opportunities can easily be confused with ADHD. Furthermore, increasing the age of onset from 7 to 12 years is likely to further increase the growing rate of girls diagnosed with the inattentive subtype of ADHD because inattention often occurs or becomes a problem after the age of 7 years (Staller and Faraone, 2006). "
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