Clinical correlates of ADHD in females: Findings from a large group of girls ascertained from pediatric and psychiatric referral sources

Objective: The scientific literature about attention-deficit hyperactivity disorder (ADHD) is based almost exclusively on male subjects, and girls wit h ADHD may be underidentified and undertreated. The aim of this study was t o examine clinical correlates of ADHD in females using comprehensive assess ments in multiple domains of functioning. Method: Subjects were 140 girls w ith ADHD and 122 comparison girls without ADHD ascertained from pediatric a nd psychiatric referral sources of the same age and social class. Subjects, were assessed with structured diagnostic interviews, psychometric tests as sessing intellectual functioning and academic achievement, as well as stand ardized assessments of interpersonal, school, and family functioning by rat ers who were blind to clinical diagnosis. Results: Compared with female con trols. girls with ADHD were more likely to have conduct, mood, and anxiety disorders; lower IQ and achievement scores; and more impairment on measures of social, school, and family functioning. Conclusions: These results exte nd to girls previous findings in boys indicating that ADHD is characterized by prototypical core symptoms of the disorder, high levels of comorbid psy chopathology, and dysfunction in multiple domains. These results not only s upport findings documenting phenotypic similarities between the genders but also stress the severity of the disorder in females.