Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition characterised by persistent patterns of inattention (difficulty sustaining focus, organising tasks, following instructions), hyperactivity (excessive motor activity, inability to remain seated) and impulsivity (acting without thinking, interrupting, difficulty waiting) — to a degree that interferes significantly with functioning in school, work, relationships or daily life. It affects approximately 5.9% of children and 2.8% of adults globally.

ADHD is highly heritable — approximately 74-80% genetic contribution in twin studies. Hundreds of common genetic variants (GWAS studies) contribute small effects; rare copy number variants contribute larger risks. Neurobiologically, ADHD involves dysregulation of dopamine and noradrenaline neurotransmission in prefrontal cortical circuits (affecting executive functions) and the striatum (affecting reward processing and motivation). Environmental risk factors (low birthweight, prematurity, prenatal tobacco or alcohol exposure, maternal stress) modestly increase risk in genetically susceptible individuals. ADHD is NOT caused by bad parenting, sugar, screen time or vaccines.

Does ADHD persist into adulthood?

Yes — more than 50% of children with ADHD continue to meet full diagnostic criteria in adulthood; an additional 30-40% have subthreshold symptoms causing significant impairment. Adult ADHD typically has fewer hyperactivity symptoms but persistent inattention and executive dysfunction. It frequently goes unrecognised — adults receive diagnoses of depression, anxiety, bipolar disorder or burnout without the underlying ADHD being identified. Recognition of adult ADHD has dramatically increased in recent years.

Children under 6: behavioural therapy first-line (parent training programmes such as Incredible Years, Triple P — reduce ADHD severity and improve parenting efficacy); medication second-line. Children 6+: combination of medication and behavioural therapy is optimal. First-line medications: stimulants (methylphenidate — WHO Essential Medicine; amphetamines). Non-stimulant alternatives: atomoxetine, guanfacine/clonidine (alpha-2 agonists), viloxazine. Adults: stimulants (methylphenidate, lisdexamfetamine) and atomoxetine are evidence-based; CBT for adults with ADHD addresses skills and strategies.

Why are girls and women with ADHD missed?

Girls with ADHD more commonly present with the predominantly inattentive subtype — less disruptive in classrooms, therefore less likely to be referred for evaluation. Girls develop stronger compensatory strategies (masking) — appearing more organised and socially capable at the cost of enormous cognitive effort. ADHD assessment tools were historically developed and normed on male populations. Girls with ADHD receive diagnoses an average of 4-5 years later than boys. Undiagnosed ADHD in women is associated with higher rates of anxiety, depression, eating disorders and self-harm.

What are the risks of untreated ADHD?

Untreated ADHD is associated with substantially elevated risks: academic underachievement and school dropout; occupational difficulties and unemployment; relationship instability; substance use disorders (ADHD is a major risk factor — stimulant treatment reduces this risk); road traffic accidents (inattention while driving); risk-taking behaviour; self-harm and suicidal ideation; anxiety and depression; and financial difficulties. ADHD medication treatment substantially reduces these risks.

Is ADHD overdiagnosed?

The question of whether ADHD is overdiagnosed is debated. Prevalence estimates from rigorous epidemiological studies (5.9% in children) are broadly consistent globally — but clinical diagnosis rates vary dramatically between countries and regions, suggesting both under- and over-diagnosis depending on context. In some countries (e.g. US) clinical diagnosis rates exceed global epidemiological prevalence estimates, raising overdiagnosis concerns. In many LMICs, ADHD is severely underdiagnosed. The key is accurate, comprehensive assessment — not quick checklists — to ensure those who need treatment receive it and those who don't are not medicated.

How does GMJ News cover ADHD?

GMJ News covers WHO ADHD data, stimulant and non-stimulant medication evidence, adult ADHD recognition, female ADHD underdiagnosis, and parent training programme efficacy. ADHD is a significant neurodevelopmental condition in Georgia — directly relevant to PHIG's child and adult mental health priorities.

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ADHD

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Attention deficit hyperactivity disorder (ADHD) — characterised by persistent, impairing inattention, hyperactivity and impulsivity — affects approximately 5.9% of children and 2.8% of adults globally (approximately 366 million adults), making it the most common neurodevelopmental condition in childhood and a frequently unrecognised condition in adults (WHO). ADHD is associated with substantially elevated risks of academic underachievement, relationship difficulties, substance use disorders, road traffic accidents and unemployment. Stimulant medications (methylphenidate, amphetamines) — the most studied medications in child psychiatry — are highly effective; behavioural therapy is first-line in children under 6.

Key messages

366 million adults, 5.9% of children

ADHD affects approximately 5.9% of children and 2.8% of adults globally — equating to approximately 366 million adults — making it the most common neurodevelopmental condition. Most childhood ADHD persists into adulthood, though often unrecognised (WHO).

Stimulants are the most evidence-based treatment

Methylphenidate and amphetamines are the most studied medications in paediatric psychiatry — with the strongest evidence base in child medicine. They improve core ADHD symptoms significantly and reduce associated impairments in school, work and relationships.

Adult ADHD — massively underdiagnosed

Most adults with ADHD remain undiagnosed — receiving diagnoses of depression, anxiety, burnout or relationship difficulties without the underlying ADHD being recognised. Adult ADHD carries elevated risk of accidents, substance use, job loss and relationship breakdown.

Females systematically missed

ADHD is diagnosed 2-3 times more often in boys than girls — but females are significantly underdiagnosed. Girls often present with predominantly inattentive ADHD (less disruptive than hyperactive-impulsive type) and may mask symptoms more effectively through academic and social effort.

Co-occurring conditions are the rule

Approximately 70-80% of people with ADHD have at least one co-occurring condition — including anxiety disorders, depression, learning disabilities (dyslexia, dyscalculia), sleep disorders, ODD/conduct disorder, and autism spectrum disorder.

Behavioural therapy first-line under 6

WHO and major guidelines recommend behavioural therapy as the first-line intervention for preschool children under 6 with ADHD — before medication. Parent training programmes (Incredible Years, Triple P) are highly effective and without medication side effects.

Key statistics

5.9%

global prevalence in children

WHO/Polanczyk meta-analysis

2.8%

global prevalence in adults

WHO/Fayyad meta-analysis

366M

estimated adults with ADHD globally

WHO

2-3:1

male to female ratio (girls systematically missed)

WHO

70-80%

of ADHD patients have at least one co-occurring condition

WHO

>50%

of childhood ADHD persists into adulthood

WHO/research

ADHD global prevalence estimates by age group (%) — WHO/meta-analyses

Source: WHO and published meta-analyses. ADHD persists into adulthood in the majority but is rarely diagnosed.

Glossary of key terms

ADHD presentations (DSM-5)
APA/WHODSM-5 defines three presentations: predominantly inattentive (ADHD-I — difficulty sustaining attention, easily distracted, forgetful); predominantly hyperactive-impulsive (ADHD-HI — fidgeting, excessive talking, interrupting, difficulty waiting); and combined presentation (ADHD-C — most common in clinical settings).

Methylphenidate (Ritalin, Concerta)
WHO EML/FDAThe most prescribed ADHD medication globally — a dopamine and noradrenaline reuptake inhibitor. Available as immediate-release (4-6 hour) and extended-release formulations (8-12 hours). WHO Essential Medicine for ADHD in children. Effective for approximately 70-80% of children with ADHD.

Amphetamines (Adderall, Vyvanse)
FDA/NICEMixed amphetamine salts (Adderall) and lisdexamfetamine (Vyvanse) — FDA-approved for ADHD in children and adults. Slightly more effective than methylphenidate on average in some studies (AHRQ meta-analysis). Lisdexamfetamine is a pro-drug — reducing abuse potential.

Atomoxetine (Strattera)
FDA/NICE/WHOA selective noradrenaline reuptake inhibitor (SNRI) — non-stimulant ADHD treatment. First-line when stimulants are contraindicated (cardiac conditions, history of psychosis, significant anxiety, substance use risk) or not tolerated. Slower onset (4-6 weeks to full effect). Also approved for adults.

Executive functions
NeuropsychologyHigher-order cognitive skills regulated by prefrontal cortex circuits — including working memory, inhibitory control, cognitive flexibility, planning and organisation. ADHD primarily impairs executive functions through dopaminergic-noradrenergic dysregulation in fronto-striatal-cerebellar circuits — not from lack of intelligence or motivation.

ADHD masking
ResearchLike autism, ADHD individuals — especially girls and women — develop compensatory strategies to conceal ADHD symptoms in social and academic settings. Masking is cognitively exhausting and associated with late diagnosis, anxiety, depression and burnout.