ADHD underdiagnosed in girls

The newsletter of the Hyperactive Children’s Support Group recently reported on research from 1999 (Biederman J et al. Journal of the American Academy of Child and Adolescent Psychiatry) that had studied a large group of girls both with and without ADHD.

David Rabiner, PhD, Senior Research Scientist at Duke University who runs a research update site on ADHD (, comments that ‘the results of this study make clear that ADHD in girls is as serious a condition and has just as negative impact on children's functioning and adjustment as it does in boys.

Overall, the correlates of ADHD in girls were remarkably similar to what is known to be true for boys. Among the few differences found were that girls were less likely to be diagnosed with oppositional defiant disorder or conduct disorder than boys and more likely to have problems related to substance use (smoking etc). Rates of mood and anxiety disorders, and impairment in academic functioning appeared comparable.

The lower rates of disruptive behaviour problems, along with the preponderance of inattentive rather than hyperactive symptoms, may partially explain why ADHD in girls may often not be recognised. However, the authors stress that clinicians need to be aware that, despite their lower rates of disruptive disorders, ADHD in girls is a serious condition associated with impairment in multiple areas of children's functioning. There is no reason to assume that the treatment of girls with ADHD should be any less aggressive or comprehensive than that of boys.

Parents need to be aware that almost 50% of girls with ADHD also had at least one other diagnosable disorder. It is thus essential that evaluations of girls for ADHD take a broad look at their emotional, behavioural, social, and academic functioning. Given the possible increased risk of substance use in girls with ADHD, this may be an area that is especially important for parents to monitor.

First published in February 2007

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