Girls with ADHD: Watch for depression and eating disorders
Two researchers reported some chilling findings in a symposium at the American Academy of Child and Adolescent Psychiatry 54th Annual Meeting, which was held this past October.
Their studies showed that girls with ADHD are more likely to suffer major depression and eating disorders that non-ADHD girls. Girls who have both ADHD and eating disorders were also more at risk for having significantly higher rates of major depression, anxiety disorders, and disruptive behavior disorder. Further, those with both ADHD and major depression had an earlier onset of the major depression and a higher rate of suicide than the control (non-ADHD) group.
Drs. Joseph Biederman and Craig B. H. Surman, both from Massachusetts General Hospital in Boston, published their findings in the Journal of Developmental & Behavioral Pediatrics Journal of Developmental Behavior (2007;28:302).
Here is what they found:
- Girls with ADHD were 3.6 times more likely to develop an eating disorder, defined as either anorexia or bulimia nervosa.
- At the 5-year follow-up, 16% of the girls with ADHD (20 girls) and 5% of the controls (5 girls) developed an eating disorder.
- Girls with ADHD were 5.6 times more likely to develop bulimia and 2.7 times more likely to develop anorexia nervosa.
- In a longitudinal study of 140 girls with ADHD and 122 girls without ADHD, girls with ADHD were 5.4 times more likely to develop major depression than girls without ADHD.
- Major depression developed on average at age 17 years and lasted twice as long in the girls with ADHD vs controls (3 years vs 1.3 years).
- Parents with a history of major depression and girls with a history of prior mania predicted depression among the ADHD girls studied.
The depression study consisted of 140 girls with ADHD and 122 girls without ADHD, who were enrolled at an academic medical center through referrals by community psychiatrists and pediatricians. The ages of the girls at the time the study began were aged 6-18 years and they were then followed for 5 years, during which time they were given various assessments.
The eating disorder study included 125 adolescent girls with ADHD and 100 adolescent girls without ADHD. In the 5 years of follow-up, 20 girls with ADHD and 5 girls without ADHD developed an eating disorder (either anorexia nervosa or bulimia nervosa).
What can we conclude from these studies?
These studies suggest that girls with ADHD are at higher risk for developing major depression and eating disorders. Parents need to keep a keen eye on how their daughters are faring and must watch for any signs that could point to either of these potentially devastating illnesses.
Girls need to have their ADHD properly treated and must be moderated closely by their doctors and therapists. We know that eating disorders and depression correlate highly with suicides, so it's imperative that families and treating clinicians are aware of the risks associated with girls who have ADHD.
Further, we need more studies on girls and women with ADHD. It's only been in recent years that there has been more of a focus on this population, as most studies have been on boys with ADHD. According to Dr. Biederman, "Almost all of the available research on ADHD has been based on underpowered, cross-sectional studies of preteen and teenage males."
Hopefully the scientific community will realize the paucity of research on girls and women and will pump up their efforts. But in the meantime, it will be up to parents, teachers and clinicians to keep a close eye on our ADHD girls.