title: Absence of gender effects on attention deficit hyperactivity disorder: findings in nonreferred subjects.
abstract: OBJECTIVE
  In a previous study, the authors found that, compared with referred boys with attention deficit hyperactivity disorder (ADHD), girls are less likely to manifest comorbid disruptive behavior disorders and learning disabilities--characteristics that could adversely affect identification of ADHD in girls. However, because referral bias can affect outcome, these findings require replication in nonreferred groups of ADHD subjects.
  
  
  METHODS
  The authors evaluated gender effects in a large group of nonreferred siblings (N=577) of probands with ADHD and non-ADHD comparison subjects. Ninety-eight of the nonreferred siblings (N=73 males, N=25 females) met the criteria for diagnosis of ADHD, and 479 (N=244 males, N=235 females) did not meet those criteria. All siblings were systematically and comprehensively assessed with measures of emotional, school, intellectual, interpersonal, and family functioning. The assessment battery used for the siblings was the same as that used for the probands.
  
  
  RESULTS
  The nonreferred males and females with ADHD did not differ in DSM-IV subtypes of ADHD, psychiatric comorbidity, or treatment history. They also showed similar levels of cognitive, psychosocial, school, and family functioning.
  
  
  CONCLUSIONS
  These findings suggest that the clinical correlates of ADHD are not influenced by gender and that gender differences reported in groups of subjects seen in clinical settings may be caused by referral biases.
authors.affiliation: Clinical and Research Program in Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. jbiederman@partners.org
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Anne
authors.initials: A
authors.lastname: Kwon
authors.forename: Megan
authors.initials: M
authors.lastname: Aleardi
authors.forename: Virginie-Anne
authors.initials: VA
authors.lastname: Chouinard
authors.forename: Teresa
authors.initials: T
authors.lastname: Marino
authors.forename: Heather
authors.initials: H
authors.lastname: Cole
authors.forename: Eric
authors.initials: E
authors.lastname: Mick
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D015983:Selection Bias; D012737:Sex Factors; D035781:Siblings / Q000523:psychology*