Reuters Health

Girls With ADHD Less Likely Than Boys With ADHD to Be Disruptive

Friday, July 23, 1999

WESTPORT -- The core symptoms of attention-deficit hyperactivity disorder (ADHD) in girls are similar to those of boys with ADHD, Massachusetts researchers report. But girls with ADHD are less likely than boys with ADHD to exhibit disruptive behavior. According to the investigators, this difference may explain why girls are less often referred for treatment.

Dr. Joseph Biederman, of Massachusetts General Hospital, and colleagues there and elsewhere in Boston studied 140 girls with a diagnosis of ADHD and 122 girls without the disorder, all between the ages of 6 and 18 years.

Girls with ADHD had "...prototypical symptoms of the disorder," Dr. Biederman's team reports in the August issue of the Journal of the American Academy of Child and Adolescent Psychiatry. Inattention was the most common symptom.

Compared with controls, girls with ADHD exhibited "...high levels of comorbidity with mood and anxiety disorders, as well as significant impairments in cognitive, interpersonal, school, and family functioning," the team says.

The investigators found that conduct disorder and oppositional defiant disorder were less than half as prevalent in the girls with ADHD as in boys with ADHD, based on previously published data from a study of boys by Dr. Biederman and others.

"Because comorbidity with disruptive behaviors is associated with behavioral deviance and aggression, and because these problems drive clinical referral, the lower rates of these disorders in girls may lead to the underrecognition of ADHD in girls and account for the marked gender differences frequently reported in clinical samples of children with ADHD," the study group writes.

The authors conclude that "...there is no reason to assume that the treatment of girls with ADHD should be any less aggressive than that of boys with ADHD."

J Am Acad Child Adolesc Psychiatry 1999;38:966-975.