Gender differences in adult attention-deficit/hyperactivity disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

Abstract

Background: Gaining insight into possible gender differences in the clinical presentation of adults with attention-deficit/hyperactivity disorder (ADHD) is of relevance in order to conduct appropriate screening and treatment interventions in both genders.

Method: The analyses compared (1) prevalence and sociodemographic correlates, (2) frequency of ADHD core symptoms, (3) rates of subtypes, (4) prevalence of comorbid mental health conditions, and (5) rates of risky/impulsive behaviors, as well as health and social correlates, in men and women with ADHD in a nationally representative, US population–based sample. Face-to-face psychiatric interviews were conducted according to DSM-IV criteria in 34,653 adults from the US National Epidemiologic Survey on Alcohol and Related Conditions (Wave 2, 2004–2005).

Results: While the prevalence of lifetime ADHD was significantly higher in men than in women (OR = 1.46, 95% CI = 1.22–1.76), the rate of persistent ADHD did not significantly differ across genders (OR = 1.23, 95% CI = 0.96–1.58). Compared to men with persistent ADHD, women with persistent ADHD, despite having lower rates of hyperactive symptoms, presented with similar ADHD subtypes profile and rates of risky behaviors (except for reckless driving), as well as with significantly more anxiety and perceived mental health impairment (P = .032). Results were similar when considering lifetime ADHD.

Conclusions: Our findings show that, despite different symptom profiles and comorbidities, men and women have similar rates of current ADHD and of risky behaviors associated with the disorder. Women with ADHD should receive as much attention as their male counterparts.

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ORCID for Samuele Cortese: orcid.org/0000-0001-5877-8075

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