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Cited by 480Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentAutism Spectrum Disorder Research

Sex and Age Differences in Attention-Deficit/Hyperactivity Disorder Symptoms and Diagnoses: Implications for DSM-V and ICD-11

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Ramtekkar, Ujjwal P., Reiersen, Angela M., Todorov, Alexandre A., Todd, Richard D.·2010·Journal of the American Academy of Child & Adolescent Psychiatry
DOI 10.1016/j.jaac.2009.11.011PMC PMC3101894
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Abstract

Objective To examine gender and age differences in attention-deficit/hyperactivity disorder (ADHD) symptom endorsement in a large community-based sample. Method Families with four or more full siblings ascertained from Missouri birth records completed telephone interviews regarding lifetime DSM-IV ADHD symptoms and the Strengths and Weaknesses of ADHD-Symptoms and Normal-behavior (SWAN) questionnaire for current ADHD symptoms. Complete data were available for 9,380 subjects aged 7 through 29 years. Lifetime and current DSM-IV-like ADHD diagnoses were assigned by the DSM-IV symptom criteria. Linear regression was used to examine sex and age effects on SWAN ADHD symptom scores. Logistic regression was used to examine sex and age effects on specific ADHD diagnoses. Fractional polynomial graphs were used to examine ADHD symptom count variations across age. Results Overall prevalence of current DSM-IV-like ADHD was 9.2% with a male:female ratio of 2.28:1. The prevalence of DSM-IV-like ADHD was highest in children. Gender differences in DSM-IV-like ADHD subtype prevalences were highest in adolescents. On average, individuals with lifetime DSM-IV-like ADHD diagnoses had elevated current ADHD symptoms even as adolescents or adults. Conclusions Lower male:female ratios than reported in some clinic-based studies suggest that females are underdiagnosed in the community. Although they may no longer meet the full symptom criteria, young adults with a history of lifetime DSM-IV-like ADHD maintain higher levels of ADHD symptoms compared with the general population. The use of age-specific diagnostic criteria should be considered for DSM-V and ICD-11.

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  • Differences in results between children and adults are consistent with the fact that there may be remission of symptoms in adults with ADHD.

    “Differences in results between children and adults are consistent with the fact that there may be remission of symptoms in adults with ADHD (Barkley et al., 2002; Ramtekkar et al., 2010).”

    From Predictive coding in neuropsychiatric disorders: a systematic transdiagnostic review. (2025) · cites this paper as Ramtekkar et al., 2010

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Authors
Ramtekkar, U. P., Reiersen, A. M., Todorov, A. A., & Todd, R. D.
Affiliations
Washington University in St. Louis (US)
Corresponding author
Reiersen, Angela M.
ORCID
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2010-03
Volume
49
Issue
3
Pages
217-228.e3
ISSN
0890-8567 (ISSN-L)
DOI
10.1016/j.jaac.2009.11.011
PMC
PMC3101894
OpenAlex
W2001183909
Cited by
480
References
4
Citations by year
2026: 7 · 2025: 17 · 2024: 51 · 2023: 38 · 2022: 48 · 2021: 53 · 2020: 33 · 2019: 34 · 2018: 33 · 2017: 29 · 2016: 24 · 2015: 31 · 2014: 18 · 2013: 26 · 2012: 14
FWCI
13.56
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01MH083823, R01MH067921, K08MH080287)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
attention deficit hyperactivity disorder, sex differences, age differences, ADHD prevalence, DSM-5 diagnostic criteria, ICD-11 diagnostic criteria, young adults, adolescents, community sample
MeSH terms
Adolescent, Adult, Age Factors, Attention Deficit Disorder with Hyperactivity, Child, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Mass Screening, Missouri, Personality Assessment, Psychometrics, Sex Factors, Cohort Studies, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Young Adult

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