India v/s the USA: A Comparative Review of the Prevalence and Neurobiology of ADHD Amongst Women

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder marked by persistent inattention and/or hyperactivity-impulsivity, categorized into inattentive, hyperactive, and combined presentations. Although global research on ADHD has expanded, gender-specific evidence, particularly for women, remains sparse. This systematic review compared prevalence and neurobiology of ADHD in adult women in India and the United States. A total of 11,800 records were screened, with eight studies meeting inclusion criteria. In India, prevalence estimates ranged widely from 5.48% to 25.7%, with most studies failing to report female-specific rates; however, one clinical sample indicated women comprised nearly half of adult ADHD cases. In contrast, U.S. data provided clearer gender distinctions: 6.18% of females and 12.41% of males were diagnosed with ADHD, confirming women’s consistent underrepresentation. Neurobiological studies were absent in Indian samples, while U.S. research reported increased brain iron load and associated neuroaxonal vulnerability in adults with ADHD. These findings underscore a critical gap in female-focused ADHD research, particularly in India, and highlight the need for neurobiological studies and culturally sensitive diagnostic approaches to address underdiagnosis and heterogeneity in women’s ADHD.