The evolving global burden of ADHD: A comprehensive analysis and future projections (1990-2046)

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood, affecting cognitive, behavioral, and social functions, and imposing a substantial global economic burden.

ADHD often persists into adulthood, creating ongoing challenges for healthcare systems worldwide. This study provides a comprehensive assessment of the global ADHD disease burden, including future projections to inform long-term public health strategies.

The global incidence, prevalence, and disability-adjusted life years (DALYs) for ADHD in 2021 were assessed by age-standardized rates. Temporal trends from 1990 to 2021 were analyzed using estimated annual percentage change (EAPC) derived from log-linear regression models, while cluster analysis examined regional variations across the Global Burden of Disease (GBD) regions. Future projections for ADHD burden over the next 25 years were made using ARIMA and BAPC models.

Between 1990 and 2021, global ADHD incidence, prevalence, and DALYs increased by 9.92 %, 18.71 %, and 18.57 %, respectively, with the highest burden among children and adolescents. Males consistently exhibited higher rates across all measures. High and high-middle Socio-demographic Index (SDI) regions experienced an increase in ADHD burden, whereas low SDI regions showed stable or declining trends. BAPC projections indicate continued growth in ADHD cases, with a particularly steep rise anticipated among females, indicating a potential narrowing of the historical gender gap in ADHD prevalence.

ADHD remains a major global health issue, with significant disparities across regions, genders, and socio-demographic groups. Targeted, evidence-based healthcare strategies are crucial to address these challenges and mitigate ADHD socio-economic impact globally.