Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment.

In youth, ADHD is more commonly diagnosed in males than females, but higher male-to-female ratios are found in clinical versus population-based samples, suggesting a sex bias in the process of receiving a clinical diagnosis of ADHD. This study investigated sex differences in the severity and present...

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Publicado en:European Child & Adolescent Psychiatry Vol. 28; no. 4; pp. 481 - 490
Autores principales: Mowlem, Florence D., Rosenqvist, Mina A., Martin, Joanna, Lichtenstein, Paul, Asherson, Philip, Larsson, Henrik
Formato: research tables/charts Journal Article
Publicado: Springer Nature Apr2019
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment.
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          Mowlem, Florence D.
          Rosenqvist, Mina A.
          Martin, Joanna
          Lichtenstein, Paul
          Asherson, Philip
          Larsson, Henrik
        affil: Social, Genetic, and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology and Neuroscience, King's College London, DeCrespigny Park, Denmark Hill, SE5 8AF, London, UK
      sug:
        subj:
          Attention Deficit Hyperactivity Disorder Diagnosis
          Attention Deficit Hyperactivity Disorder Drug Therapy
          Sex Factors
          Predictive Research
          Male
          Female
          Sweden
          Severity of Illness
          Hyperkinesis
          Impulsive Behavior
          Confidence Intervals
          Human
          Odds Ratio
          Child
          Child: 6-12 years
          Male
          Female
      ab: In youth, ADHD is more commonly diagnosed in males than females, but higher male-to-female ratios are found in clinical versus population-based samples, suggesting a sex bias in the process of receiving a clinical diagnosis of ADHD. This study investigated sex differences in the severity and presentation of ADHD symptoms, conduct problems, and learning problems in males and females with and without clinically diagnosed ADHD. We then investigated whether the predictive associations of these symptom domains on being diagnosed and treated for ADHD differed in males and females. Parents of 19,804 twins (50.64% male) from the Swedish population completed dimensional assessments of ADHD symptoms and co-occurring traits (conduct and learning problems) when children were aged 9 years. Children from this population sample were linked to Patient Register data on clinical ADHD diagnosis and medication prescriptions. At the population level, males had higher scores for all symptom domains (inattention, hyperactivity/impulsivity, conduct, and learning problems) compared to females, but similar severity was seen in clinically diagnosed males and females. Symptom severity for all domains increased the likelihood of receiving an ADHD diagnosis in both males and females. Prediction analyses revealed significant sex-by-symptom interactions on diagnostic and treatment status for hyperactivity/impulsivity and conduct problems. In females, these behaviours were stronger predictors of clinical diagnosis (hyperactivity/impulsivity: OR 1.08, 95% CI 1.01, 1.15; conduct: OR 1.43, 95% CI 1.09, 1.87), and prescription of pharmacological treatment (hyperactivity/impulsivity: OR 1.24, 95% CI 1.02, 1.50; conduct: OR 2.20, 95% CI 1.05, 4.63). Females with ADHD may be more easily missed in the ADHD diagnostic process and less likely to be prescribed medication unless they have prominent externalising problems.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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