Global, Regional, and National Epidemiology of Attention Deficit Hyperactivity Disorder in Children From 1990 to 2021, with Projections to 2051

J Child Neurol. 2026 Aug 5:8830738261464418. doi: 10.1177/08830738261464418. Online ahead of print.

ABSTRACT

BackgroundAttention deficit hyperactivity disorder (ADHD) in children is a common neuropsychiatric disease in the world, which has a significant impact on children, families, and society.AimsThis study aims to examine the trends in ADHD incidence, prevalence, and disability-adjusted life years (DALYs) among children to guide preventive measures.MethodThis cross-sectional analysis used data from the Global Burden of Diseases (GBD) spanning 1990 to 2021 across 204 nations and territories. Children diagnosed with ADHD aged ≤14 years were incorporated into the analysis. The main outcome measures include incidence, prevalence, DALYs, case changes, and estimated annual percentage changes (EAPCs). The trends were categorized by location, nation, age, sex, and Socio-Demographic Index (SDI). Meanwhile, an age-period-cohort (APC) model is used to estimate net drifts, local drifts, longitudinal age curves, and the period relative risks. Bayesian APC (BAPC) models were used to anticipate the global burden of ADHD from 2022 to 2051. Data were analyzed from September 10, 2024, to September 25, 2024.ResultsA total of 33 429 324 children (73.14% male; 26.86% female) were included in the analysis. There were 4 111 621 children with ADHD cases globally in 2021. From 1990 to 2021, pediatric ADHD cases rose 9.92% (95% uncertainty interval [UI], 7.13%-13.16%). Over the past 32 years, the global incidence rate decreased from 215.08 (95% UI, 146.23-314.58) to 204.37 (95% UI, 137.94-295.99), whereas prevalent cases increased from 29 564 63 to 33 429 32. DALYs increased from 362 607 to 410 706, with the middle-SDI region having the highest incidence and DALY rate in 2021. Incidence increased most in Western Europe (EAPC, 0.50%), whereas prevalence increased most rapidly in South Asia (EAPC, 0.33%). In 2021, Australia had the highest national incidence (638.35), prevalence (5295.68), and DALYs (65.13) among 204 nations. High-SDI regions had the highest net drift in both incidence rate and prevalence rate (0.21% for each). APC analysis showed that the burden of ADHD exhibited significant age, period, and cohort dependencies, with notable sex and regional heterogeneity. Incidence and prevalence were significantly higher in males than females, although the gender gap has recently narrowed (eg, incidence rate ratio in 2019.5: male 0.97, female 0.96). Furthermore, incidence rates in high-SDI regions worsened over time and across birth cohorts. BAPC model predicts that ADHD incidence will continue to rise, reaching 247.68 incidence rate by 2051 and 4 468 925 incident cases. The number of prevalent cases is projected to reach 25 357 194, and the DALY rate will rise to 23.93.ConclusionsChildhood ADHD represents a growing global public health challenge, with projected increases in incidence, prevalence, and DALYs, particularly in high-middle-SDI regions. Concurrently, DALY rates are rising most rapidly in low-SDI areas. Enhanced understanding of the epidemiology of childhood ADHD may inform targeted prevention and management strategies.

PMID:42555032 | DOI:10.1177/08830738261464418