Sex Differences in Substance Use, Prevalence, Pharmacological Therapy, and Mental Health in Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD)

Abstract

Sex differences are poorly studied within the field of mental health, even though there is evidence of disparities (with respect to brain anatomy, activation patterns, and neurochemistry, etc.) that can significantly influence the etiology and course of mental disorders. The objective of this work was to review sex differences in adolescents (aged 13–18 years) diagnosed with ADHD (according to the DSM-IV, DSM-IV-TR and DSM-5 criteria) in terms of substance use disorder (SUD), prevalence, pharmacological therapy and mental health. We searched three academic databases (PubMed, Web of Science, and Scopus) and performed a narrative review of a total of 21 articles. The main conclusions of this research were (1) girls with ADHD are more at risk of substance use than boys, although there was no consensus on the prevalence of dual disorders; (2) girls are less frequently treated because of underdiagnosis and because they are more often inattentive and thereby show less disruptive behavior; (3) together with increased impairment in cognitive and executive functioning in girls, the aforementioned could be related to greater substance use and poorer functioning, especially in terms of more self-injurious behavior; and (4) early diagnosis and treatment of ADHD, especially in adolescent girls, is essential to prevent early substance use, the development of SUD, and suicidal behavior.

Adjuvant Therapy for Attention in Children with ADHD Using Game-Type Digital Therapy

“…NeuroWorld DTx is also expected to play a role in reducing drug dependency [ 50 , 51 ]. According to previous studies, in the case of ADHD, there is a higher risk of comorbidity in girls, as compared with boys, diagnosed with ADHD depending on the environment [ 52 ]. Owing to the nature of psychiatric research on children and adolescents, it is difficult to obtain a sample of study participants, and it is known that the prevalence of ADHD in boys is more than twice that in girls; thus, the number of actual hospital visits is considerably lower for girls than for boys.…”

Advances in the role of the GADD45 family in neurodevelopmental, neurodegenerative, and neuropsychiatric disorders

“…ADHD is a childhood neurodevelopmental disorder characterized by persistent deficits in attention, hyperactivity, and impulsive behavior. The prevalence of ADHD in the pediatric population ranges from 5 to 10% ( Castellano-García and Benito, 2022 ). Primarily instigated by genetic factors, the heritability of this condition reaches an estimable 74% ( Faraone and Larsson, 2019 ).…”

Sexual Differences in Addictions and Dual Disorders: Importance of Gender Perspective

“…Despite these recommendations, sex differences are poorly studied within the field of mental health, even though there is evidence of disparities (with respect to brain anatomy, activation patterns, and neurochemistry, etc.) that can significantly influence the aetiology and course of mental disorders [ 6 ]. The same occurs in the study of addictions and dual diagnosis, where research continues to be carried out mainly in male patients [ 1 ].…”

“…Therefore, this Special Issue aims to update our knowledge of the sexual and gender differences found in research into addictions and dual diagnosis. Thus, the articles included in this special issue cover both issues related to gender [ 1 , 7 ] and sex [ 6 , 8 , 9 ], patients using various substances [ 1 , 6 , 7 ] or others with specific substance use disorders (SUDs) [ 8 , 9 ], and including both issues related to addictions [ 9 ] and dual diagnosis [ 1 , 6 , 7 , 8 ].…”

“…Castellano-Garcia et al (2022) [ 6 ] reviewed sex differences in the prevalence of SUDs, pharmacological therapy, and mental health in adolescents (aged 13–18 years) diagnosed with attention deficit hyperactivity disorder (ADHD). The main conclusions of their study were that (1) girls with ADHD were more at risk of substance use than boys, although there was no consensus on the prevalence of dual disorders; (2) the prevalence of ADHD was lower in girls: fewer girls were diagnosed with ADHD than boys and they had fewer symptoms and so were less likely to receive treatment; (3) girls with ADHD scored higher for cognitive and motor impulsivity and had more impaired neuropsychological profiles in terms of executive functions, although ADHD was associated with worse academic performance in both sexes; (4) ADHD was related to psychological problems and distress in both sexes, although girls may have a greater tendency towards self-injurious behaviour; and (5) early diagnosis and treatment of ADHD, especially in adolescent girls, is essential to prevent early substance use, the development of SUDs, and suicidal behaviour.…”