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An item-level systematic review of the presentation of ADHD in females

Tamara Williams, Louise Horstmann, Laiba Kayani, Annabelle Xiao Hui Lim, Abigail Russell, Tamsin Ford, Ann John Orcid Logo, Kapil Sayal, Anita Thapar, Kate Langley, Joanna Martin

Neuroscience & Biobehavioral Reviews, Volume: 171, Start page: 106064

Swansea University Author: Ann John Orcid Logo

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DOI (Published version): 10.1016/j.neubiorev.2025.106064

Abstract

Previous studies examining sex differences in attention deficit hyperactivity disorder (ADHD) have primarily examined total or subscale scores. This systematic review aimed to examine which symptoms contribute to the female presentation of ADHD at an item-level. Six research literature databases wer...

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Published in: Neuroscience & Biobehavioral Reviews
ISSN: 0149-7634 1873-7528
Published: Elsevier Ltd 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa68988
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spelling 2025-02-28T10:20:01.8480671 v2 68988 2025-02-28 An item-level systematic review of the presentation of ADHD in females ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2025-02-28 MEDS Previous studies examining sex differences in attention deficit hyperactivity disorder (ADHD) have primarily examined total or subscale scores. This systematic review aimed to examine which symptoms contribute to the female presentation of ADHD at an item-level. Six research literature databases were searched for studies comparing ADHD symptoms and their impact at an item-level in females with ADHD compared with: 1) males with ADHD and 2) females without ADHD. Thirteen studies were included. In childhood, females were more likely to display the symptoms 'fails to sustain attention in tasks' and 'often easily distracted', whereas males were more likely to display the symptoms 'often fidgets', 'difficulty remaining seated when required', 'runs/climbs in situations when inappropriate', 'always on the go', 'often noisy in playing', 'difficulty waiting turn', 'often blurts out answers' and 'often interrupts others'. In adulthood, females were more likely to endorse the symptoms 'easily distracted', 'difficulty organising tasks', 'blurts out answers' and 'talks excessively', as well as to report mind wandering and adverse home impacts. Females with ADHD differ in their symptom profile to males with ADHD, highlighting the need for future research to identify and characterise symptoms typical of female ADHD. Journal Article Neuroscience & Biobehavioral Reviews 171 106064 Elsevier Ltd 0149-7634 1873-7528 ADHD; Attention deficit hyperactivity disorder; Sex Differences; Symptoms; Item-level; Missed Diagnosis; Impact 1 4 2025 2025-04-01 10.1016/j.neubiorev.2025.106064 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This study was funded by the Welsh Government through Health and Care Research Wales via a National Institute for Health and Care Research (NIHR) Advanced Fellowship (Ref: NIHR-FS(A)-2022). This report is independent research supported by the National Institute for Health Research NIHR Advanced Fellowship - Stage 2, Dr Abigail Russell, NIHR300591. KS and TF are NIHR Senior Investigators. The views expressed are those of the authors and not necessarily those of the NHS, NIHR or the Department of Health and Social Care. 2025-02-28T10:20:01.8480671 2025-02-28T10:08:14.9571600 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Tamara Williams 1 Louise Horstmann 2 Laiba Kayani 3 Annabelle Xiao Hui Lim 4 Abigail Russell 5 Tamsin Ford 6 Ann John 0000-0002-5657-6995 7 Kapil Sayal 8 Anita Thapar 9 Kate Langley 10 Joanna Martin 11 68988__33705__fe6f1b4913a24e1ba60d4a3096f87be2.pdf 68988.VOR.pdf 2025-02-28T10:14:06.5137055 Output 3373012 application/pdf Version of Record true © 2025 The Authors. This is an open access article distributed under the terms of the Creative Commons CC-BY license. true eng http://creativecommons.org/licenses/by/4.0/
title An item-level systematic review of the presentation of ADHD in females
spellingShingle An item-level systematic review of the presentation of ADHD in females
Ann John
title_short An item-level systematic review of the presentation of ADHD in females
title_full An item-level systematic review of the presentation of ADHD in females
title_fullStr An item-level systematic review of the presentation of ADHD in females
title_full_unstemmed An item-level systematic review of the presentation of ADHD in females
title_sort An item-level systematic review of the presentation of ADHD in females
author_id_str_mv ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Ann John
author2 Tamara Williams
Louise Horstmann
Laiba Kayani
Annabelle Xiao Hui Lim
Abigail Russell
Tamsin Ford
Ann John
Kapil Sayal
Anita Thapar
Kate Langley
Joanna Martin
format Journal article
container_title Neuroscience & Biobehavioral Reviews
container_volume 171
container_start_page 106064
publishDate 2025
institution Swansea University
issn 0149-7634
1873-7528
doi_str_mv 10.1016/j.neubiorev.2025.106064
publisher Elsevier Ltd
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
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description Previous studies examining sex differences in attention deficit hyperactivity disorder (ADHD) have primarily examined total or subscale scores. This systematic review aimed to examine which symptoms contribute to the female presentation of ADHD at an item-level. Six research literature databases were searched for studies comparing ADHD symptoms and their impact at an item-level in females with ADHD compared with: 1) males with ADHD and 2) females without ADHD. Thirteen studies were included. In childhood, females were more likely to display the symptoms 'fails to sustain attention in tasks' and 'often easily distracted', whereas males were more likely to display the symptoms 'often fidgets', 'difficulty remaining seated when required', 'runs/climbs in situations when inappropriate', 'always on the go', 'often noisy in playing', 'difficulty waiting turn', 'often blurts out answers' and 'often interrupts others'. In adulthood, females were more likely to endorse the symptoms 'easily distracted', 'difficulty organising tasks', 'blurts out answers' and 'talks excessively', as well as to report mind wandering and adverse home impacts. Females with ADHD differ in their symptom profile to males with ADHD, highlighting the need for future research to identify and characterise symptoms typical of female ADHD.
published_date 2025-04-01T05:53:59Z
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