Clinical Presentation of Attention-Deficit Hyperactivity Disorder Symptoms in Terms of Gender and Chronological Age

Document Type : Brief report


1 Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

2 Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran


The present cross-sectional study aimed to evaluate Attention-deficit hyperactivity disorder (ADHD)
symptoms in terms of gender and age. Based on convenience sampling, the data records of 1,184
children and adolescents with ADHD were gathered from various Child and Adolescent Psychiatry
Clinics affiliated to Shiraz University of Medical Sciences (Shiraz, Iran). During 2010-2015, the
patients had been interviewed face-to-face for ADHD diagnosis in accordance with the Diagnostic
and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) diagnostic criteria. The collected
data were re-analyzed using parent-reported ADHD symptoms measured with the DSM-IV clinical
symptoms checklist. Statistical analysis was performed using SPSS software with the Pearson
correlation test, Chi-square test, and t test. PThe mean age of the participants was 9.29±2.55 years, 904 (76.40%) of whom were boys. The mean total score of hyperactivity-impulsivity in girls and boys was 2.63±2.77 and 3.19±8.17, respectively. The mean total score of inattention in girls and boys was 3.40±1.97 and 3.28±2.00, respectively. Age
and gender were not associated with the symptoms of inattentive ADHD. The symptoms associated
with hyperactivity-impulsivity had a significant association with age (P<0.05). The symptoms with a
statistically significant association with gender were frigidity (P=0.001), often running about (P=0.03),
and often difficulties with playing or leisure activities (P=0.005). The most common symptoms of
inattentive ADHD in both boys and girls were “inattention to details or making careless mistakes”
(47.6% and 54.3%, respectively) and “fails to finish work” (43.0% and 40.1%, respectively).
In contrast with the hyperactivity-impulsivity, the severity of inattention was not associated with
age. The results of the present study indicated that while the ADHD screening questions for inattention
could be the same for both genders, they should be different for hyperactivity-impulsivity.



    1. Prakash S, Meshram S, Ramtekkar U. Athletes, yogis and individuals with sedentary lifestyles; do their lung functions differ? Indian Journal of Physiology and Pharmacology. 2007;51:76-80.
    2. Mohammadi MR, Salmanian M, Ghanizadeh A, et al. Psychological problems of Iranian children and adolescents: parent report form of Strengths and Difficulties Questionnaire. Journal of Mental Health. 2014;23:287-91.
    3. Ramtekkar UP, Reiersen AM, Todorov AA, Todd RD. Sex and age differences in attention-deficit/hyperactivity disorder symptoms and diagnoses: implications for DSM-V and ICD-11. Journal of the American Academy of Child and Adolescent Psychiatry. 2010;49:217-28.
    4. Todd RD, Huang H, Todorov AA, et al. Predictors of stability of attention-deficit/hyperactivity disorder subtypes from childhood to young adulthood. Journal of the American Academy of Child and Adolescent Psychiatry. 2008;47:76-85.
    5. Lubke GH, Hudziak JJ, Derks EM, et al. Maternal ratings of attention problems in ADHD: evidence for the existence of a continuum. Journal of the American Academy of Child and Adolescent Psychiatry. 2009;48:1085-93.
    6. Gao Q, Qian Y, He XX, et al. Childhood predictors of persistent ADHD in early adulthood: Results from the first follow-up study in China. Psychiatry Research. 2015;230:905-12.
    7. Hurtig T, Ebeling H, Taanila A, et al. ADHD symptoms and subtypes: relationship between childhood and adolescent symptoms. Journal of the American Academy of Child and Adolescent Psychiatry. 2007;46:1605-13.
    8. Waschbusch DA, King S. Should sex-specific norms be used to assess attention-deficit/hyperactivity disorder or oppositional defiant disorder? Journal of Consulting and Clinical Psychology. 2006;74:179-85.
    9. Grevet EH, Bau CH, Salgado CA, et al. Lack of gender effects on subtype outcomes in adults with attention-deficit/hyperactivity disorder: support for the validity of subtypes. European archives of psychiatry and clinical neuroscience. 2006;256:311-9.
    10. Ohan JL, Johnston C. Gender appropriateness of symptom criteria for attention-deficit/hyperactivity disorder, oppositional-defiant disorder, and conduct disorder. Child Psychiatry and Human Development. 2005;35:359-81.
    11. Willcutt EG, Nigg JT, Pennington BF, et al. Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes. Journal of Abnormal Psychology. 2012;121:991-1010.
    12. Ghanizadeh A. Parents reported oral sensory sensitivity processing and food preference in ADHD. Journal of Psychiatric and Mental Health Nursing. 2013;20:426-32.
    13. American Psychiatric Association. Diagnostic and statistical manual of mental disorders.4th ed. Virginia (USA): American Psychiatric Association; 2000.
    14. Ghanizadeh A, Jafari P. Cultural structures of the Persian parents’ ratings of ADHD. Journal of Attention Disorders. 2010;13:369-73.
    15. Mohamad*Esmaile E, Alipour A. Preliminary evaluation of validity and reliability and determining the cutting points of disorder in children’s symptom questionnaire (CSI-4). Research on Exceptional Children. 2002;(5):239-254. [In Persian]
    16. Rosch KS, Mostofsky SH, Nebel MB. ADHD-related sex differences in fronto-subcortical intrinsic functional connectivity and associations with delay discounting. Journal of Neurodevelopmental Disorders. 2018;10:34.
    17. Patros CHG, L Sweeney K, Mahone EM, et al. Greater delay discounting among girls, but not boys, with ADHD correlates with cognitive control. Child Neuropsychology. 2018;24:1026-46.
    18. Murray AL, Booth T, Eisner M, et al. Sex differences in ADHD trajectories across childhood and adolescence. Developmental Science. 2019;22:e12721.