Event Title
Sex and Gender Differences in Attention-Deficit / Hyperactive disorder (ADHD): A Literature Review
Location
Philadelphia, PA
Start Date
3-5-2023 1:00 PM
End Date
3-5-2023 4:00 PM
Description
Background:
The American Medical Women's Association (AMWA) Sex and Gender Health Collaborative identified the need for a concise factsheet for clinicians outlining sex and gender differences in Attention Deficit Hyperactive Disorder (ADHD) as ADHD is underdiagnosed, undertreated, and frequently misdiagnosed in women due to lack of recognition of gender-specific presentation. AMWA's goal is to improve access and exposure to sex and gender differences in healthcare as few medical schools educate students on these differences. The poster summarizes the reviewed literature on the prevalence, diagnosis, referral for, prevention, clinical presentation, and treatment of ADHD with a goal to reduce sex and gender related disparities in the diagnosis and treatment of ADHD. The literature reviewed typically used gender and sex interchangeably.
Methods:
A Pubmed and Google Scholar search was performed using the search terms “ADHD,” “women,” “sex specific symptoms,” “gender specific symptoms,” “sex specific presentation,” “gender specific presentation.” A total of 25 peer reviewed sources were selected for review.
Results:
ADHD in girls and women can be misdiagnosed due to comorbidities such as anxiety and depression, with girls more likely to be treated with antidepressants before receiving necessary ADHD treatment compared to boys. Girls may also be misdiagnosed with dysthymia or bipolar disorder. In childhood, girls with ADHD may be perceived as compliant and daydreamers, and cultural misrepresentation and stigma may prevent self-identification. Low self-esteem and impaired peer relationships are common. Prevalence ratios of diagnosed females to males vary from 1:1.8 to 1:16 in children and estimated 1:1.6 in adults. Gender bias contributes to the referral gap between males and females, with teachers more likely to refer boys than girls with equivalent symptom profiles. Diagnosis is based on DSM-5 criteria, but girls' coping mechanisms may mask symptoms. Somatic complaints, poor relationships with peers, anxiety, and poor self-esteem may be initial clues to the impact of ADHD symptoms on women.
Discussion:
Women with ADHD are frequently underdiagnosed, undertreated, and misdiagnosed due to a lack of recognition of gender-specific symptoms. A thorough understanding of these symptoms, as well as the impact of comorbid conditions and masking, is necessary for accurate diagnosis. Differences in referral and diagnostic rates between males and females are influenced by cultural perception and externalizing vs internalizing factors. Girls and women with ADHD are more likely to exhibit inattention, emotional reactivity, decreased self-esteem, and risky behavior, and satisfactory academic performance does not rule out the possibility of ADHD. Somatic symptoms, peer relationship struggles, and poor self-esteem may be the first indicators of underlying ADHD in some women.
Embargo Period
6-28-2023
Sex and Gender Differences in Attention-Deficit / Hyperactive disorder (ADHD): A Literature Review
Philadelphia, PA
Background:
The American Medical Women's Association (AMWA) Sex and Gender Health Collaborative identified the need for a concise factsheet for clinicians outlining sex and gender differences in Attention Deficit Hyperactive Disorder (ADHD) as ADHD is underdiagnosed, undertreated, and frequently misdiagnosed in women due to lack of recognition of gender-specific presentation. AMWA's goal is to improve access and exposure to sex and gender differences in healthcare as few medical schools educate students on these differences. The poster summarizes the reviewed literature on the prevalence, diagnosis, referral for, prevention, clinical presentation, and treatment of ADHD with a goal to reduce sex and gender related disparities in the diagnosis and treatment of ADHD. The literature reviewed typically used gender and sex interchangeably.
Methods:
A Pubmed and Google Scholar search was performed using the search terms “ADHD,” “women,” “sex specific symptoms,” “gender specific symptoms,” “sex specific presentation,” “gender specific presentation.” A total of 25 peer reviewed sources were selected for review.
Results:
ADHD in girls and women can be misdiagnosed due to comorbidities such as anxiety and depression, with girls more likely to be treated with antidepressants before receiving necessary ADHD treatment compared to boys. Girls may also be misdiagnosed with dysthymia or bipolar disorder. In childhood, girls with ADHD may be perceived as compliant and daydreamers, and cultural misrepresentation and stigma may prevent self-identification. Low self-esteem and impaired peer relationships are common. Prevalence ratios of diagnosed females to males vary from 1:1.8 to 1:16 in children and estimated 1:1.6 in adults. Gender bias contributes to the referral gap between males and females, with teachers more likely to refer boys than girls with equivalent symptom profiles. Diagnosis is based on DSM-5 criteria, but girls' coping mechanisms may mask symptoms. Somatic complaints, poor relationships with peers, anxiety, and poor self-esteem may be initial clues to the impact of ADHD symptoms on women.
Discussion:
Women with ADHD are frequently underdiagnosed, undertreated, and misdiagnosed due to a lack of recognition of gender-specific symptoms. A thorough understanding of these symptoms, as well as the impact of comorbid conditions and masking, is necessary for accurate diagnosis. Differences in referral and diagnostic rates between males and females are influenced by cultural perception and externalizing vs internalizing factors. Girls and women with ADHD are more likely to exhibit inattention, emotional reactivity, decreased self-esteem, and risky behavior, and satisfactory academic performance does not rule out the possibility of ADHD. Somatic symptoms, peer relationship struggles, and poor self-esteem may be the first indicators of underlying ADHD in some women.