Gender Influence in Attention-deficit/hyperactivity Disorder Treatment: a Systematic Review

Abstract

Introduction

the influence of hormones in various psychological aspects of attention deficits are being studied increasingly more often and their significance has been acknowledge. However, hormonal fluctuations and the influence of estrogen on the brain has not been considered or treated. Recent studies show the influence of estrogen in the functioning and the functional consequences, observing an improvement in functioning, particularly in attention, of women during phases with high levels of estrogen. This can influence the treatment of Deficit Attention/Hyperactivity (ADHD) in females.

Methodology

a systematic review was performed, searching for studies on the following databases: MEDLINE (PubMed), The Cochrane Library and EMBASE. The search was made using the Medical Subject Headings (MeSH) terms 'Sex/gender”, 'Response treatment” and 'ADHD/Attention-Deficit/Hyperactivity Disorder. Limiters were applied and Boolean logic used to expand and restrict searches. A total of 208 articles were identified, and 6 were included.

Results

three main findings were identified: treatment with stimulant drugs is effective independent of gender; women had more complex presentation of ADHD, with more comorbidities such as depression and anxiety and women had one statistically significant gender-by-treatment response, but only on emotional dysregulation.

Conclusions

it is as yet uncertain as to the role of gender in the treatment of ADHD. While some evidence is more persuasive than others, results still can not be used safely by the medical community. Therefore further more study needs to be carried out to clarify the answer to this question.