Adult ADHD presentations in an Indian tertiary care setting: Gender perspectives

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neuro-developmental disorder with skewed gender ratio presentations. Women are more likely to present with internalizing disorders, often diagnosed with comorbid disorders than adult-ADHD. One hundred and one treatment-seeking adults (18-45 years; 78 men, 23 women), were recruited at a Tertiary Health Care (THC) and assessed on ASRS, executive functions, emotion-regulation, an Indian social-cognition battery, and self-report of functioning. Gender differences were examined using the Mann-Whitney U-test and Independent samples t-test. The mean age of sample was 26 years, majority were single, from urban settings. Women had significantly greater mean scores on ASRS, significantly greater self-reported mind-wandering, hyper-focusing, motor-coordination difficulties, reduced self-esteem, tendency towards demoralization, and mood lability. Women had higher illness-severity, often identified upon screening. The majority met full-threshold criteria for ADHD, and only a few had subclinical-ADHD. Trends indicate low help-seeking in women, with atypical primary complaints. Women were more likely to be diagnosed with personality disorder than ADHD. There were no gender differences in executive functions, emotion regulation and functioning. These preliminary findings are likely to aid contextualizing adult-ADHD in women in India, allowing for early recognition and management of adult-ADHD across gender.