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Women With ADHD Benefit From Treatment: Presented at ECNP

By Mark Pownall

AMSTERDAM, THE NETHERLANDS -- October 27, 2005 -- Women with attention deficit hyperactivity disorder (ADHD) "are often undertreated and underdiagnosed, yet could benefit substantially from treatment," according to researchers who analyzed results of 2 studies.

The analysis adds to limited data on gender differences in adults with ADHD, said Fred W. Reimherr, MD, associate professor of psychiatry, Mood Disorders Clinic, University of Utah, Salt Lake City, Utah.

Dr. Reimherr presented the data here on October 24^th at the 18^th Congress of the European College of Neuropsychopharmacology (ECNP).

The 2 10-week, placebo-controlled studies evaluated adult subjects using the Connors' Adult ADHD Rating Scale (CAARS) and the Wender-Reimherr Adult Attention Disorder Deficit Scale (WRAADDS), as well as the Hamilton rating scales for Depression and Anxiety (HAM-A and HAM-D).

Results show that 75% of the 188 women and 62% of the 348 men had combined forms of ADHD. In younger patients, inattention is more common among girls with ADHD than in boys, Dr. Reimherr said. But this did not hold true in the adult population in the 2 studies, in which 24% of the women and 35% of the men were diagnosed as having inattention only (P = .005).

Combined hyperactive/inattentive ADHD was observed in 1% of the women and 3% of the men in the studies, a statistically significant difference (P = .005).

On both scales studied, CAARS WRAADDS, and their subscales, the women had more ADHD symptoms and they were significantly more likely than the men studied to have emotional dysregulation and hyperactivity.

Emotional dysregulation includes measurement of temper, irritability, mood lability, and emotional reactivity.

Women in the study were more likely to have an affective disorder, particularly depression, and were significantly more anxious and depressed than the men, according to scores on the HAM-A and HAM-D.

However, there were no differences between men and women for psychological well being according to subscales that measured anxiety/tension, vitality/drive, self-discipline/control, depression, and somatic health, Dr. Reimherr said.

Women had worse scores than men in the areas of workplace and social functioning, with differences that approached statistical significance, while in the areas of family and total functioning, women's scores were statistically worse than men's.

According to responses on the WRAADDS, women with ADHD who were treated with atomoxetine had higher scores than men on the emotional dysregulation subscale, which remained significant after controlling for baseline differences. Dr. Reimherr noted that women did better on atomoxetine than men for most measures, but the only significant difference was in the emotional dysregulation subscale.

Treatment improved about twice the proportion of all patients compared with placebo. Atomoxetine improved 30% of the women and 28% of the men, compared with 16% and 19% for placebo, according to the WRADDS total scale, with similar figures for the CAARS scale.

The studies were supported by funding from Lilly Research Laboratories. The analysis was performed at the University of Utah with no external support.

Citation: Journal of the European College of Neuropsychopharmacology. 2005;15 (suppl 3):S604.

REFERENCES:
1. Biederman J, et al. Influence of gender on attention deficit hyperactivity disorder in children referred to a psychiatric clinic. Am J Psychiatry. 2002;159(1):36-42.
2. Gershon J, et al. A meta-analytic review of gender differences in ADHD. J Atten Disord. 2002;5(3):143-154.
3. Michelson D, et al. Atomoxetine in adults with ADHD: Two randomized, placebo-controlled studies. Biol Psychiatry. 2003;53(2):112-120.


[Presentation title: Gender Differences in Adults With ADHD, Pretreatment and Following Treatment With Atomoxetine Under Double-Blind Conditions. Abstract P.7.027]

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