Research shows girls with ADHD are at higher risk for other mental health issues.

Girls with attention deficit hyperactivity disorder are at higher risk than girls without ADHD for multiple mental disorders that often lead to cascading problems such as abusive relationships, teenage pregnancies, poor grades and drug abuse, UCLA psychologists report in the journal Pediatrics.

The researchers, who conducted by far the most comprehensive analysis of girls and ADHD, report: 37.7 percent of girls with ADHD met criteria for an anxiety disorder, compared with only 13.9 percent of girls without ADHD. 10.3 percent of girls with ADHD were diagnosed with depression compared with only 2.9 percent without ADHD. 42 percent of girls with ADHD were diagnosed with oppositional defiant disorder, compared with just 5 percent of girls without it.12.8 percent of girls with ADHD were diagnosed with conduct disorder compared with only 0.8 percent without ADHD. Conduct disorder is similar to oppositional defiant disorder, but with more severe behavioral problems, such as committing violent acts, setting fires and hurting animals.

“We knew the girls with ADHD would have more problems than the girls without ADHD, but we were surprised that conduct disorder and oppositional defiant disorder were at the top of the list, not depression or anxiety,” said Steve Lee, a UCLA associate professor of psychology and senior author of the study.

“These conduct disorders, more than anxiety and depression, predict severe adult impairments, such as risky sexual behavior, abusive relationships, drug abuse and crime.” Symptoms of ADHD include being easily distracted, fidgeting, being unable to complete a single task and being easily bored.
Most ADHD studies focused on boys, or compared girls with ADHD to boys with ADHD – not to girls without ADHD. ADHD is often harder to detect in girls than in boys because girls with the disorder may appear disengaged, forgetful or disorganized, and perceived as “Spacey” and stay “Under the radar” without being referred for assessment and treatment, said lead author Irene Tung, a UCLA graduate student in psychology and National Science Foundation graduate research fellow.

What should concerned parents do? If a child’s negative behavior lasts for months and is adversely affecting her or his social relationships and school performance, then it’s worth having your child evaluated by a psychologist or psychiatrist for ADHD and other mental disorders. “People tend to think of girls as having higher risk for depression and anxiety disorders, and boys as being more likely to exhibit conduct disorders, but we found that ADHD for girls substantially increases their risk for these conduct disorders,” Tung said.

 “The child’s behavior will often get worse before it gets better.” Children with ADHD are two to three times more likely than children without the disorder to develop serious substance abuse problems in adolescence and adulthood, Lee and colleagues reported in 2011.

To receive a diagnosis of ADHD by a child psychologist or psychiatrist, a child must have at least six of nine symptoms of either hyperactivity or inattention, the child’s behavior must be causing problems in his or her life, and the symptoms must not be explainable by any medical condition or any other mental disorder.

Press release: An ADHD diagnosis puts girls at much higher risk for other mental health problems
DOI: 10.1542/peds.2016-0430