Attention-Deficit Hyperactivity Disorder in Girls

ArticleinCNS Drugs 20(2):107-23 · February 2006with39 Reads
DOI: 10.2165/00023210-200620020-00003 · Source: PubMed
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.
    • "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). "
    [Show abstract] [Hide abstract] 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.
    Full-text · Article · Feb 2015
    • "Some studies find that more women than men are diagnosed with ADHD in adulthood (Groenewald et al. 2009) and that women are less frequently diagnosed with H/I-symptoms in childhood than males (Rucklidge 2010). Girls with ADHD are also reported to suffer from internalizing symptoms of anxiety and depression and comorbid mental disorders more frequently than boys (Staller and Faraone 2006), although it is questionable whether these differences are maintained in adulthood (Quinn 2008). In a study of adult ADHD, Grevet et al. (2006) found no significant sex differences as regards ADHD subtypes or psychiatric comorbidity. "
    [Show abstract] [Hide abstract] ABSTRACT: Few studies have examined the impact of childhood attention deficit hyperactivity disorder (ADHD) symptoms on adult ADHD functional outcomes. To address this issue dimensionally, ADHD symptoms in childhood and adulthood and their relation to educational deficits and work disability are studied in a clinical sample of adult patients with previously untreated ADHD. About 250 adults diagnosed systematically with ADHD according to DSM-IV were prospectively recruited. Primary outcomes were high school dropout and being out of the work last year. Childhood ADHD symptoms, sex differences, comorbidities of other mental disorders, and adult ADHD symptoms were examined by historical data, clinician interviews, and questionnaires. High levels of ADHD symptom severity in childhood were related to dropping out of high school [odds ratio (OR) = 3.0], as were higher numbers of hyperactive-impulsive symptoms in childhood. Significantly, more women than men were long-term work disabled (OR = 2.0). After adjusting for age and gender, persisting high levels of ADHD inattention symptoms in adulthood (OR = 2.5), number of comorbid disorders, and particularly anxiety disorders were significantly related to long-term work disability. Childhood hyperactive-impulsive symptoms and overall severity of childhood ADHD symptoms were associated with high school dropout rates; however, persisting ADHD inattention symptoms and comorbid mental disorders in adulthood were more correlated to occupational impairment. These findings underline proposals for studies on early recognition and interventions for ADHD and psychiatric comorbidity. They further suggest that inattentive symptoms be a focus of adult ADHD treatment and that workplace interventions be considered to prevent long-term work disability.
    Full-text · Article · Feb 2014
    • "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. "
    [Show abstract] [Hide abstract] ABSTRACT: This work aims to understand the features among 5- to 15-year-old children with attention deficit hyperactivity disorder (ADHD) in Zhabei District in Shanghai. Children with ADHD were studied using general background questionnaire, ADHD symptom rating questionnaire, and cluster-stratified sampling. A total of 9,900 valid questionnaires were utilized in this study. We conducted diagnostic interviews with suspected ADHD children and their parents using the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th Edition) for ADHD. The prevalence rate of ADHD among the children was 4.6%, of which 2.4%, 0.4%, and 1.8% had ADHD-I ADHD-HI, and ADHD-C types, respectively. The prevalence rates in boys and girls were 6.6% and 2.7% (ratio, 2.41 : 1), respectively. Significant differences in prevalence rate were found among children with different age groups and ADHD types. Children aged 7-10 years had the highest prevalence rate (6.3%). Externally, residence children had higher prevalence than local residents. Significant differences in prevalence rate were also found among children with parents having different educational and socioeconomic level. The prevalence of ADHD-HI was higher than the other two types. The highest prevalence was observed in 7- to 10-year-old children. The influential factors of ADHD prevalence were age, gender, and educational level.
    Full-text · Article · Dec 2013
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