Elsevier

Biological Psychiatry

Volume 55, Issue 7, 1 April 2004, Pages 692-700
Biological Psychiatry

Original article
Gender effects on Attention-Deficit/Hyperactivity disorder in adults, revisited

https://doi.org/10.1016/j.biopsych.2003.12.003Get rights and content

Abstract

Background

This study reexamined gender differences in a large sample of adults with attention-deficit/hyperactivity disorder (ADHD).

Methods

We assessed the effects of ADHD, gender, and their interaction on rates of psychiatric comorbidity and cognitive functioning in 219 adults with ADHD who were referred to an outpatient psychiatric clinic over the last 7 years compared with 215 control subjects group-matched to control subjects on age and gender, and ascertained from ongoing family genetic case control adults with ADHD.

Results

There was no evidence that gender moderated the association between ADHD and other psychiatric disorders. Attention-deficit/hyperactivity disorder was associated with cognitive deficits and higher rates of major depression, anxiety, substance use disorders, and antisocial personality disorder.

Conclusions

Attention-deficit/hyperactivity disorder in adults is associated with psychiatric and cognitive impairment in both genders. These results bear striking similarities to findings reported in pediatric samples, supporting the validity of ADHD and stressing the importance of identifying and treating the disorder in adulthood.

Section snippets

Methods and materials

Attention-deficit/hyperactivity disorder subjects were adults clinically referred for treatment to a psychiatric outpatient facility at a large urban hospital from September of 1993 to February of 1999. This study did not include any of the subjects analyzed in our prior report of adult ADHD (Biederman et al 1994) evaluated in the early 1990s. Control subjects were nonreferred parents of non-ADHD proband children from two identically designed family genetic case-control studies of ADHD (

Demographic characteristics of sample

The ADHD sample consisted of 219 subjects (82 female subjects, 137 male subjects), with a mean age of 37.6 ± 10.5. The control sample consisted of 215 subjects (81 female subjects, 134 male subjects), with a mean age of 38.7 ± 4.2. There were no significant differences between the ADHD and control groups in gender (Pearson χ21 = .003, p = .96) or age (t432 = 1.37, p = .17). Thus, the matching procedure succeeded in balancing the groups on these potentially confounding factors. The ratio of male

Discussion

This study reexamined gender differences in a new, large sample of male and female adults with and without ADHD evaluated over the last 7 years. Interaction models provided no evidence that gender moderated the association between ADHD and the phenotypic expression of the disorder, the prevalence of lifetime or current comorbid psychiatric disorders, or patterns of cognitive and psychosocial functioning. These results are remarkably consistent with previous findings reported in adults with

Acknowledgements

This work was supported, in part, by Grants from United States Public Health Service (National Institute of Mental Health), Grant RO1 MH-41314-01A2 (JB) and RO1 MH 57934 (SVF). Parts of this work were presented at the Annual Meeting of the American Psychiatric Association, May 2002, Philadelphia, Pennsylvania.

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