Factors Impacting Gender Diagnostic Differences in ADHD: A Review

Abstract

ADHD is a neurodevelopmental disorder commonly diagnosed in children. To date, it is more commonly diagnosed in boys compared to girls although there has been no significant difference reported in adulthood. The objective of this review is to investigate various factors affecting gender differences in ADHD including, historical context, symptom presentation, age of onset, physician biases, and comorbidities. This review includes literature from a variety of academic databases such as Web of Science, MEDLINE, ERIC, PubMed as well as from grey literature. Our findings include systemic gender discrepancies that exist in the reported prevalence, diagnosis, and treatment of ADHD. Additionally, there are several gender-based factors that may contribute to the differences in ADHD presentation for girls including a more inattentive subtype, later age of onset, and misdiagnosis due to comorbidities. This discrepancy in diagnosis has been attributed to various factors which include ineffective diagnostic criteria, physician bias, and comorbidities. Limitations of this review include evident gaps in the literature on the association between ADHD and non-binary gender development, misdiagnosis of girls with comorbidities, as well as differences in the effectiveness of treatment on different genders. Furthermore, there is little standardization in methods and variables collected, especially the minimal recruitment of female participants. Lastly, future studies should investigate the impact of clinical versus community-based settings on children with ADHD.