title: The impact of sex and subtypes on cognitive and psychosocial aspects of ADHD.
abstract: We compared the effect of sex and attention-deficit-hyperactivity disorder (ADHD) subtyping in groups of females and males. One hundred and one females with ADHD (mean age 10y 4mo [SD 2y 8mo]; range 5y-18y) were classified according to subtype by Diagnostic and Statistical Manual of Mental Disorders (4th edn) criteria (inattentive [ADHD-I]; combined [ADHD-C]) and balanced by subtype to 101 males (mean age 10y 5mo [SD 2y 9mo]; range 5y 4mo-17y 6mo). All children underwent IQ and reading assessment, and 109 underwent the continuous performance task (Test Of Variables of Attention [TOVA]). Parents completed the Conners' Abbreviated Rating Scale (ABRS), the Child Behavior Checklist (CBCL), learning disability questionnaires, and reported use and efficacy of methylphenidate. Teachers completed the Swanson, Kotkin, Agler, M-Flynn, and Pelham (SKAMP) rating scale. Sex differences were found only on the CBCL; females were more impaired on the attention (p<0.001) and somatization (p=0.028) subscales but not for IQ, other questionnaires, TOVA scores, methylphenidate treatment, or demographics. Females with ADHD-C, but not males, had significantly higher T-scores than females with ADHD-I on social, attention, delinquent, and aggressive behaviours. Regardless of sex, children with ADHD-C had higher scores on all CBCL subscales (p=0.047), ABRS (p<0.001), and SKAMP (p=0.03) than children with ADHD-I. The results support the supposition that ADHD in females is the same disorder as in males. ADHD subtyping was the important determinant of ADHD core symptoms; females with ADHD were found to have significant risk of psychopathology.
authors.affiliation: Neuropaediatric Unit, Shaare Zedek Medical Centre, Jerusalem, Israel. gros@szmc.org.il
authors.forename: Varda
authors.initials: V
authors.lastname: Gross-Tsur
authors.forename: Gil
authors.initials: G
authors.lastname: Goldzweig
authors.forename: Yael E
authors.initials: YE
authors.lastname: Landau
authors.forename: Itai
authors.initials: I
authors.lastname: Berger
authors.forename: Dorit
authors.initials: D
authors.lastname: Shmueli
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Shalev
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000145:classification / Q000523:psychology*; D049628:Body Size; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D003071:Cognition; D004522:Educational Status; D005260:Female; D006801:Humans; D007360:Intelligence; D007557:Israel; D008297:Male; D011581:Psychological Tests; D012737:Sex Factors