Gender Differences in Symptom Presentations of ASRS-Based Probable Adult ADHD Among Patients Receiving Treatment for Substance Use Disorders in Nairobi, Kenya

Abstract

Adult Attention-Deficit/Hyperactivity Disorder (ADHD) commonly co-occurs with Substance Use Disorders (SUDs), yet evidence regarding gender differences in ADHD symptom presentations among treatment-seeking populations in Sub-Saharan Africa remains limited. Understanding these differences is important for improving the identification and clinical assessment of co-occurring ADHD and SUDs. This study examined gender differences in ASRS-based probable Adult ADHD presentations among patients receiving treatment for SUDs in selected rehabilitation centres in Nairobi, Kenya. A quantitative cross-sectional analytical study was conducted among 322 adults receiving treatment for SUDs. Adult ADHD symptoms were assessed using the Adult ADHD Self-Report Scale (ASRS v1.1). Respondents who screened positive and met DSM-5-TR-aligned criteria, including symptom onset before 12 years of age, were classified into predominantly inattentive, predominantly hyperactive–impulsive, or combined presentations according to symptom domain thresholds. Of the 322 participants, 90 met the criteria for ASRS-based probable Adult ADHD and formed the screen-positive analytical sample. Descriptive statistics summarised ADHD presentations, while the chi-square test of independence examined the association between gender and ADHD presentation. Significant gender differences were observed, χ²(2, N = 90) = 38.00, p < .001, Cramer's V = .65. Among males, the combined presentation predominated (71.7%), whereas females were more frequently classified as having the inattentive presentation (59.5%). These findings demonstrate gender differences in ASRS-based probable ADHD presentations among screen-positive adults receiving treatment for SUDs and may inform ADHD screening and assessment practices in comparable rehabilitation settings.