Teenage girls with attention deficit hyperactivity disorder (ADHD) are much more likely to act out, suffer depression, and smoke than adolescents without the condition.

A new study — which may offer the best snapshot to date of teenage girls with ADHD — portrays a group that is also plagued by anxiety, eating disorders, and alcohol and drug abuse.

"As girls mature, there's a rise in mood and anxiety disorders, disruptive behaviors, and substance-abuse problems," says researcher Joseph Biederman, MD, professor of psychiatry at Harvard Medical School.

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Boys and Girls Affected Equally

Though many doctors believe that boys with ADHD are much more likely to develop these problems than girls, Biederman says his study shows that just isn't so.

"The picture of ADHD is almost identical among the genders," he says. Regardless of gender, it's advisable to screen kids with ADHD for other conditions.

Brad Reimherr, MD, associate professor of psychiatry at the University of Utah, isn't surprised. He says his own study of adult sufferers of ADHD shows that women are even more impaired than men.

"Both in terms of symptoms of hyperactivity and attention deficit itself and also in terms of other emotional ailments, women were more likely to have problems," Reimherr tells WebMD.

Part of the problem, he agrees, is that society thinks of ADHD as a male disorder. Males act out more and tend to get more attention.

Females — regardless of age — are more apt to be misdiagnosed, typically with anxiety or depression, he says. As a result, the condition often goes untreated, even though studies show that women respond well to ADHD medications, Reimherr says.

Click here to read Web MD's "Understanding ADHD and the Creative Child."

More Than 1 in 5 Act Out

The study, presented at the annual meeting of the American Psychiatric Association, included 235 teenage girls, about half of whom had ADHD. Their average age was 17.

About nine in 10 had received treatment for their disorder, usually a combination of drugs and counseling, Biederman says.

On almost every measure, the ADHD sufferers fared worse than their unafflicted counterparts:

—More than 20 percent were disruptive vs. 3 percent of those without ADHD.
—More than one in three suffered major depression, compared with three in 100 of those without ADHD.
—56 percent suffered anxiety vs. 19 percent of those without ADHD.
—4 percent drank alcohol vs. 1 percent of those without ADHD.
—12 percent used drugs compared with 4 percent of those without ADHD.
—Anorexia and bulimia each claimed about 5 percent of ADHD sufferers.

Particularly alarming, he says, is that 28 percent of the girls with ADHD smoked, compared with 13 percent of the others.

"ADHD is a clear risk factor for smoking, and girls are affected as much as boys," Biederman says.

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By Charlene Laino, reviewed by Michael W. Smith, MD

SOURCES: American Psychiatric Association 2005 Annual Meeting, Atlanta, May 21-26, 2005. Joseph Biederman, MD, professor of psychiatry, Harvard Medical School. Brad Reimherr, MD, associate professor of psychiatry, University of Utah, Salt Lake City.