Study: Oppositional Defiant and Conduct Disorders Far More Common in Girls with ADHD
A new analysis conducted by UCLA researchers suggests that girls with ADHD are not only at higher risk for anxiety disorder and depression, but also for conduct disorders more commonly associated with boys. Researchers hope that better understanding these comorbidities will aid clinicians in more accurate diagnoses for girls.
October 5, 2016
ADHD occurs in both genders equally, and is one of the most common childhood disorders, yet it remains disproportionately undiagnosed and/or misdiagnosed in girls. This is due, in part, to the medical community’s incomplete understanding of how ADHD affects and manifests in girls, specifically. Now, a new study suggests that commonplace assumptions about the incidence and type of related conditions found in girls with ADHD are also wrong.
The study, published in Pediatrics, found that young women with ADHD are substantially more likely to develop oppositional defiant disorder (ODD), anxiety, conduct disorder, and depression than those without the condition, at the following rates:
- Oppositional Defiant Disorder: 42% of girls with ADHD were diagnosed; 5% of girls without ADHD had the condition.
- Anxiety Disorder:37.7% of girls with ADHD had symptoms; 13.9% of girls without ADHD met the criteria.
- Conduct Disorder:12.8% of girls with ADHD were diagnosed; only 0.8% of girls without the condition showed symptoms.
- Depression: 10.3% of girls with ADHD had symptoms; 2.9% of girls without ADHD were diagnosed.
To arrive at these conclusions, researchers from UCLA used meta-analysis of 18 studies that analyzed 1,997 girls between ages 8 and 13. The scientists compared 796 girls with ADHD to 1,201 without the condition. Most previous research on comorbidities either focused on boys, or compared girls with ADHD to boys with ADHD. Researchers examined the rate of comorbid internalizing (anxiety, depression), and externalizing (oppositional defiant disorder, conduct disorder) psychopathy.
“We knew girls with ADHD would have more problems than 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 in a press release.
Often the difficulty with diagnosing related conditions is distinguishing symptoms that look alike and often overlap. Identifying the most common ones to look at first can help lead to a faster diagnosis and let more girls benefit from available treatments sooner.
1. Irene Tung, James J. Li, Jocelyn I. Meza, Kristen L. Jezior, Jessica S.V. Kianmahd, Patrick G. Hentschel, Paul M. O’Neil, Steve S. Lee. Patterns of Comorbidity Among Girls With ADHD: A Meta-analysis. Pediatrics, October 2016; Vol. 138 No. 4. DOI: 10.1542/peds.2016-0430