Girl with add vs adhd8/15/2023 ![]() 8 In contrast, Biederman and colleagues’ small study of non-referred subjects with ADHD (siblings of ADHD probands) did not reveal any gender differences in impairment, psychiatric comorbidity, or ADHD subtypes. 21 In a population-based Australian sample, Graetz and colleagues found the male:female prevalence ratio did not differ across ADHD subtypes, but there were gender differences in co-occurring problems and symptom-specific impairment. 20 Another review recommended a stronger focus on females in ADHD research, and more attention to ADHD subtypes in the study of gender differences. 18– 20 Gaub and Carlson suggest ascertainment in clinic settings may mask gender differences, because females in such settings are underrepresented and severely affected due to referral bias. 17 Studies exploring gender differences in prevalence and characteristics of ADHD provide inconsistent findings depending on the type of sample used. 16 In the DSM-IV field trials, the sex ratio varied across subtypes. Males are generally more likely to be diagnosed with ADHD than females, with a male to female ratio of approximately 4:1 in community samples. ![]() In addition to age differences, there are clear gender differences with respect to the prevalence of ADHD, its subtypes, and endorsement of specific DSM-IV ADHD symptoms. The authors emphasize the need for age-specific diagnostic criteria for ADHD subtypes. 13, 14 In addition, a recent longitudinal study of ADHD in twins 15 finds that the five year stability of DSM-IV based ADHD subtypes is poor, changing with the transitions from childhood to adolescence and from adolescence to adulthood. 12 Some researchers argue that the DSM is not sufficiently sensitive to developmental variations in symptom expression, making it difficult for ADHD children to meet criteria as they age. 10, 11 Faraone and colleagues estimate that the prevalence of adult ADHD at age 25 ranges from 1.2% for full threshold DSM-IV diagnosis, to 3.2% for partial remission cases. The prevalence of ADHD in adults is estimated at 2–7%, and 4% is generally accepted. 9Īs in children, prevalence estimates for adult ADHD are controversial. ![]() 8 In a recent review, Rowland and colleagues conclude that lack of large population-based epidemiologic studies limits the understanding of this disorder and that further studies are needed to ascertain the true prevalence of ADHD in the community. Some recent population-based studies that do not use DSM-IV criteria have reported prevalence of ADHD either close to DSM-IV estimates 7 or much higher. 4– 6 This variability may be due to methodological issues, such as differences in diagnostic criteria, sample ascertainment, developmental stages, tools of assessment, and rater bias. 2 DSM-IV-TR estimates prevalence at 3–7% in school aged children, 1 the CDC at 7.8% among children aged 4–17 years, 3 while other reports cite prevalence estimates ranging from 2–18% in community samples. Early reports from the community-based Great Smoky Mountains Study estimated a relatively low ADHD prevalence, in the range of 1–2% for children 9 to 13 years old. 1 Though one of the most researched psychiatric disorders in childhood, its prevalence in the population remains controversial. Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in the pediatric population.
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