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Abstract(s)
Introdução: A perturbação de hiperatividade e défice de atenção (PHDA) é uma das
perturbações do comportamento mais frequentes na infância e adolescência, com uma
prevalência de cerca de 5,3%, em todo o mundo. Esta perturbação é tipicamente mais
frequente no género masculino, no entanto, o rácio masculino:feminino (M:F) tende a
apresentar maior disparidade em amostras clínicas do que em amostras comunitárias, o que
sugere que a PHDA pode estar a ser subdiagnosticada no género feminino.
Objetivos: Esta revisão da literatura pretende descrever a evidência científica existente no
que concerne à psicopatologia da PHDA no género feminino, em comparação com o género
masculino, de forma a contribuir para uma melhor identificação e diagnóstico desta
perturbação nas raparigas, quer em contexto clínico, quer na comunidade, permitindo que
estas jovens sejam acompanhadas e tratadas atempada e adequadamente.
Métodos: A principal base de dados utilizada na pesquisa bibliográfica para esta revisão
foi a PubMed. As palavras-chave utilizadas foram as seguintes: adhd AND girls AND
(“gender differences” OR “sex differences”) AND (symptoms OR psychopathology). Esta
pesquisa foi efetuada entre 6 de novembro de 2020 e 27 de janeiro de 2021, e incluiu estudos
publicados a partir de 1 de janeiro de 2010 sobre a psicopatologia da PHDA no género
feminino, em comparação com o género masculino, em crianças e adolescentes com idade
inferior a 18 anos. Após a aplicação dos critérios de inclusão e exclusão, foram incluídos no
presente trabalho um total de 32 artigos. Finda a extração dos dados dos artigos
selecionados, procedeu-se à síntese narrativa e discussão dos principais resultados
encontrados.
Resultados: Os sintomas de PHDA são menos comuns no género feminino e este parece
apresentar mais sintomas de desatenção, embora a hiperatividade/impulsividade também
estejam frequentemente presentes quando é estabelecido o diagnóstico clínico. Os adultos
de referência, em especial os professores, demonstraram subvalorizar os sintomas de PHDA
neste género. As raparigas revelaram maior défice no raciocínio percetivo e no
planeamento, bem como uma deterioração da capacidade de tomar decisões ao longo do
tempo, em contraste com as raparigas com desenvolvimento típico (DT). O género feminino
apresenta também mais comorbilidades e diagnóstico mais tardio. Não foram encontradas
diferenças no tratamento farmacológico prescrito entre os dois géneros, com a exceção de
mais fármacos prescritos para outras patologias psiquiátricas que não a PHDA e a
administração de mais terapêutica não farmacológica, nas raparigas. O rácio M:F na
prevalência de PHDA revelou-se inferior em amostras comunitárias comparativamente a
amostras clínicas. Conclusão: A presente revisão da literatura veio salientar que a apresentação clínica da
PHDA no género feminino, apesar de ter as suas particularidades, tem uma severidade
comparável à perturbação no género masculino, quando o diagnóstico é estabelecido. Os
estudos apontam para que a prevalência de PHDA seja maior no género feminino do que
pensado anteriormente, pelo que é essencial o reconhecimento dos padrões de
comportamento apresentados por estas crianças/adolescentes, bem como otimizar os
critérios de diagnóstico e os instrumentos de avaliação, até agora mais específicos para a
apresentação da perturbação no género masculino.
Introduction: Attention deficit hyperactivity disorder (ADHD) is one of the most frequent behavioral disorders in childhood and adolescence, with a prevalence of around 5.3%, worldwide. This disorder is typically more frequent in the male gender, however, the male:female ratio (M:F) tends to show greater disparity in clinical samples than in community samples, which suggests that ADHD may be underdiagnosed in the female gender. Objective: This review of the literature aims to describe the existing scientific evidence regarding the psychopathology of ADHD in females, in comparison with males, in order to contribute to a better identification and diagnosis of this disorder in girls, both in the clinical context and in the community, allowing these young women to be accompanied and treated in an opportune and appropriate manner. Methods: The main database used in the literature search for this review was PubMed. The keywords used were as follows: adhd AND girls AND (“gender differences” OR “sex differences”) AND (symptoms OR psychopathology). This research was carried out between November 6, 2020 and January 27, 2021, and included studies published as of January 1, 2010 on the psychopathology of ADHD in females, compared to males, in children and adolescents with ADHD, age under 18 years. After applying the inclusion and exclusion criteria, a total of 32 articles were included in the present study. After the extraction of data from the selected articles, the synthesis and discussion of the main results was carried out. Results: The symptoms of ADHD are less common in females and they seem to show more symptoms of inattention, although hyperactivity/impulsivity are also frequently present when the clinical diagnosis is stablished. Reference adults, especially teachers, have been shown to underestimate the symptoms of ADHD in this gender. Girls showed a greater deficit in perceptual reasoning and planning, as well as a deterioration in the ability to make decisions over time, in contrast to girls with typical development (TD). The female gender also has more comorbidities and later diagnosis. No differences were found in the pharmacological treatment prescribed between the two genders, with the exception of more drugs prescribed for psychiatric disorders other than ADHD and the administration of more non-pharmacological therapy in girls. The M:F ratio in the prevalence of ADHD was found to be lower in population samples compared to clinical samples. Conclusion: The present literature review has highlighted that the clinical presentation of ADHD in the female gender, despite having its particularities, has a severity comparable to the disorder in the male gender, when the diagnosis is established. Studies show that the prevalence of ADHD is higher in females than previously thought, so it is essential to recognize the patterns of behavior presented by these children/adolescents, as well as to optimize the diagnostic criteria and the assessment instruments, until now more specific for the presentation of the disorder in the male gender.
Introduction: Attention deficit hyperactivity disorder (ADHD) is one of the most frequent behavioral disorders in childhood and adolescence, with a prevalence of around 5.3%, worldwide. This disorder is typically more frequent in the male gender, however, the male:female ratio (M:F) tends to show greater disparity in clinical samples than in community samples, which suggests that ADHD may be underdiagnosed in the female gender. Objective: This review of the literature aims to describe the existing scientific evidence regarding the psychopathology of ADHD in females, in comparison with males, in order to contribute to a better identification and diagnosis of this disorder in girls, both in the clinical context and in the community, allowing these young women to be accompanied and treated in an opportune and appropriate manner. Methods: The main database used in the literature search for this review was PubMed. The keywords used were as follows: adhd AND girls AND (“gender differences” OR “sex differences”) AND (symptoms OR psychopathology). This research was carried out between November 6, 2020 and January 27, 2021, and included studies published as of January 1, 2010 on the psychopathology of ADHD in females, compared to males, in children and adolescents with ADHD, age under 18 years. After applying the inclusion and exclusion criteria, a total of 32 articles were included in the present study. After the extraction of data from the selected articles, the synthesis and discussion of the main results was carried out. Results: The symptoms of ADHD are less common in females and they seem to show more symptoms of inattention, although hyperactivity/impulsivity are also frequently present when the clinical diagnosis is stablished. Reference adults, especially teachers, have been shown to underestimate the symptoms of ADHD in this gender. Girls showed a greater deficit in perceptual reasoning and planning, as well as a deterioration in the ability to make decisions over time, in contrast to girls with typical development (TD). The female gender also has more comorbidities and later diagnosis. No differences were found in the pharmacological treatment prescribed between the two genders, with the exception of more drugs prescribed for psychiatric disorders other than ADHD and the administration of more non-pharmacological therapy in girls. The M:F ratio in the prevalence of ADHD was found to be lower in population samples compared to clinical samples. Conclusion: The present literature review has highlighted that the clinical presentation of ADHD in the female gender, despite having its particularities, has a severity comparable to the disorder in the male gender, when the diagnosis is established. Studies show that the prevalence of ADHD is higher in females than previously thought, so it is essential to recognize the patterns of behavior presented by these children/adolescents, as well as to optimize the diagnostic criteria and the assessment instruments, until now more specific for the presentation of the disorder in the male gender.
Description
Keywords
Diagnóstico Género Feminino Phda Psicopatologia Sintomas