Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women

被引：227

作者：

Young, Susan ^{[1
,2
]}

Adamo, Nicoletta ^{[3
,4
]}

Asgeirsdottir, Bryndis Bjork ^{[2
]}

Branney, Polly ^{[5
]}

Beckett, Michelle ^{[6
]}

Colley, William ^{[7
]}

Cubbin, Sally ^{[8
]}

Deeley, Quinton ^{[9
,10
]}

Farrag, Emad ^{[11
]}

Gudjonsson, Gisli ^{[2
,12
]}

Hill, Peter ^{[13
]}

Hollingdale, Jack ^{[14
]}

Kilic, Ozge ^{[15
]}

Lloyd, Tony ^{[16
]}

Mason, Peter ^{[17
]}

Paliokosta, Eleni ^{[18
]}

Perecherla, Sri ^{[19
]}

Sedgwick, Jane ^{[3
,20
]}

Skirrow, Caroline ^{[21
,22
]}

Tierney, Kevin ^{[23
]}

van Rensburg, Kobus ^{[24
,25
]}

Woodhouse, Emma ^{[10
,26
]}

机构：

[1] Psychol Serv Ltd, PO 1735, London CR9 7AE, England

[2] Reykjav Univ, Dept Psychol, Reykjavik, Iceland

[3] Kings Coll London, Social Genet & Dev Psychiat Ctr, Inst Psychiat Psychol & Neurosci, London, England

[4] South London & Maudsley NHS Fdn Trust, Michael Rutter Ctr, Serv Complex Autism & Associated Neurodev Disorde, London, England

[5] Oxford ADHD & Autism Ctr, Oxford, England

[6] ADHD Act, Harrogate, N Yorkshire, England

[7] CLC Consultancy, Perth, Scotland

[8] Manor Hosp, Oxford, England

[9] South London & Maudsley NHS Fdn Trust, Bethlem Royal Hosp, Natl Autism Unit, Beckenham, Kent, England

[10] Inst Psychiat Psychol & Neurosci, Forens & Neurodev Sci, London, England

[11] South London & Maudsley NHS Fdn Trust, Maudsley Hlth, Abu Dhabi, U Arab Emirates

[12] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol, London, England

[13] Child & Adolescent Psychiat, London, England

[14] South London & Maudsley Hosp, Michael Rutter Ctr, London, England

[15] Koc Univ, Istanbul, Turkey

[16] ADHD Fdn, Liverpool, Merseyside, England

[17] ADHD & Psychiat Serv Ltd, Liverpool, Merseyside, England

[18] Tavistock & Portman NHS Fdn Trust, London, England

[19] St Thomas Hosp London, London, England

[20] Kings Coll London, Fac Nursing Midwifery & Palliat Care, London, England

[21] Cambridge Cognit, Cambridge, England

[22] Univ Bristol, Sch Psychol Sci, Bristol, Avon, England

[23] South London & Maudsley NHS Fdn Trust, Natl Specialist CAMHS, Neuropsychiat Team, London, England

[24] Adult ADHD & Team, Northampton, England

[25] CYP ADHD&ASD Serv Northamptonshire, Northampton, England

[26] Compass, London, England

来源：

BMC PSYCHIATRY | 2020年 / 20卷 / 01期

关键词：

Attention-deficit; hyperactivity disorder (ADHD); Female; Girls; Women; Identification; Treatment; Interventions; Comorbidity; Consensus; UKAP; OPPOSITIONAL-DEFIANT DISORDER; RANDOMIZED CONTROLLED-TRIALS; PROSPECTIVE FOLLOW-UP; DEFICIT/HYPERACTIVITY DISORDER; GENDER-DIFFERENCES; PSYCHIATRIC-DISORDERS; SUBSTANCE USE; ADULT ADHD; INTERNET ADDICTION; SELF-REPORT;

D O I：

10.1186/s12888-020-02707-9

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Background There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. Methods The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. Results A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. Conclusions This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women.

引用

页数：27

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