Prevalence of attention deficit hyperactivity disorder in the Arab Gulf countries: systematic review and meta-analysis


  • Bandar M. Almojarthe Department of Family Medicine, Ministry of Health, Hospital of Mental Health, Aseer, Saudi Arabia



ADHD, Arab Gulf, Prevalence, Systematic review, Meta-analysis


Attention deficit hyperactivity disorder (ADHD) is an important growing psychiatric health problem of children and adolescents all over the world. This review aimed to investigate the prevalence of ADHD in the Arab Gulf countries. A literature search was conducted on 14 January 2022. Any paper reporting the prevalence of ADHD in Arab Gulf countries was included. R software was used for the meta-analysis. We included 14 papers. The prevalence of ADHD was 5.90% (95% confidence interval (CI)=1.73-20.14). We found no significant difference in the prevalence of ADHD between males and females (odds ratio (OR)=1.48; 95% CI=0.53-4.14; p value=0.456). The leave-one-out sensitivity analysis did not change the statistical significance proving that a single study did not drive the pooled effect size. Regarding parents’ educational level, the prevalence was the highest among children born to fathers with at least a secondary education 51% (95% CI= 22.97-100.00), while the prevalence rate was comparable among those with primary school education 16.6% (95% CI=1.28-100.00) and illiterate fathers 17% (95% CI=12.84-22.59). The difference between different education subgroups was statistically significant (p=0.040). There were no statistically significant differences in ADHD prevalence when comparing different mothers’ educational levels (p=0.260). The estimated cumulative evidence is high but comparable with the reported worldwide rates. Unlike these studies, the prevalence of ADHD was not associated with gender or maternal education. On the other hand, the highest prevalence of ADHD was found among children of fathers with at least a secondary education.


American Pychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, VA. 2013. Available at: https://www. Accessed on 11 November 2022.

World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. 1992. Available at: 37958. Accessed on 11 November 2022.

Kendell RE. Diagnostic and statistical manual of mental disorders. Volume 3. American Psychiatric Association Washington, DC. Am J Psychiatry. 1988;145(10):1301-2.

Thapar A, Cooper M. Attention deficit hyperactivity disorder. Lancet (London, England). 2016;387(10024):1240-50.

Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet (London, England). 2013;382(9904):1575-86.

Leibson CL, Long KH. Economic implications of attention-deficit hyperactivity disorder for healthcare systems. PharmacoEconom. 2003;21(17):1239-62.

Hodgkins P, Arnold LE, Shaw M, Caci H, Kahle J, Woods AG, et al. A systematic review of global publication trends regarding long-term outcomes of ADHD. Front Psychiatry. 2011;2:84.

Thomas R, Sanders S, Doust J, Beller E, Glasziou P. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics. 2015;135(4):e994-1001.

Faraone SV, Sergeant J, Gillberg C, Biederman J. The worldwide prevalence of ADHD: is it an American condition? World Psychiatry. 2003;2(2):104-13.

Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. 2014;43(2):434-42.

Scahill L, Schwab-Stone M. Epidemiology of ADHD in school-age children. Child Adolescent Psychiatric Clin North Am. 2000;9(3):541-55.

Durston S. A review of the biological bases of ADHD: what have we learned from imaging studies? Mental Retard Dev Disab Res Rev. 2003;9(3):184-95.

Bloch MH, Qawasmi A. Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2011;50(10):991-1000.

Evans SW, Owens JS, Bunford N. Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. J Clin Child Adolesc Psychol. 2014;43(4):527-51.

Kos JM, Richdale AL, Hay DA. Children with attention deficit hyperactivity disorder and their teachers: A review of the literature. Int J Disab Dev Educ. 2006;53(2):147-60.

McGoey K, Eckert T, DuPaul G. Early Intervention for Preschool-Age Children with ADHDA Literature Review. J Emotional Behav Disord. 2002;10:14-28.

Alhraiwil NJ, Ali A, Househ MS, Al-Shehri AM, El-Metwally AA. Systematic review of the epidemiology of attention deficit hyperactivity disorder in Arab countries. Neurosciences (Riyadh, Saudi Arabia). 2015;20(2):137-44.

Alkhateeb JM, Alhadidi MS. ADHD Research in Arab Countries: A Systematic Review of Literature. J Attention Disord. 2019;23(13):1531-45.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration. Review. PLos Med. 2009;6(7):28.

National Heart, Lung, and Blood Institute. Quality assessment tool for observational cohort and cross-sectional studies. Avaliable at: www nhlbi nih gov/health-pro/guidelines/indevelop/cardiovascular-risk-reduction/tools/cohort. Accessed on 05 November 2015.

Ghozy S, Nam NH, Radwan I, Karimzadeh S, Tieu TM, Hashan MR, et al. Therapeutic efficacy of hepatitis B virus vaccine in treatment of chronic HBV infections: A systematic review and meta-analysis. Rev Med Virol. 2020;30(3):e2089.

Mahmoud AR, Dahy A, Dibas M, Abbas AS, Ghozy S, El-Qushayri AE. Association between sarcoidosis and cardiovascular comorbidity: A systematic review and meta-analysis. Heart Lung. 2020;49(5):512-7.

Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Identifying and measuring heterogeneity). Cochrane. 2022.

Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629-34.

Bradshaw LGK, Madeeha. Prevalence of ADHD in Qatari School-Age Children. J Attention Disord. 2017;21(5):442-9.

Al-Ghannami SS, Al-Adawi S, Ghebremeskel K, Cramer MT, Hussein IS, Min Y, et al. Attention Deficit Hyperactivity Disorder and Parental Factors in School Children Aged Nine to Ten Years in Muscat, Oman. Oman Med J. 2018;33(3):193-9.

Al-Sharbati M, Al-Lawatiya S, Al-Msherfi FKH, Al-Hussaini AA. Attention-deficit hyperactivity disorder in a sample of Omani schoolboys. Canad J Psychiatry Revue Canadienne De Psychiatrie. 2004;49(8):572.

Khamis V. Attention-Deficit and Hyperactivity among School-Age United Arab Emirates Children. Int J Special Educ. 2011;26(3):28-35.

Eapen V, Mabrouk AA, Zoubeidi T, Sabri S, Yousef S, Al-Ketbi J, et al. Epidemiological study of attention deficit hyperactivity disorder among school children in the United Arab Emirates. Hamdan Med J. 2009;2(3):119-27.

Albatti TH, Alhedyan Z, Alnaeim N, Almuhareb A, Alabdulkarim J, Albadia R, Alshahrani K. Prevalence of attention deficit hyperactivity disorder among primary school-children in Riyadh, Saudi Arabia; 2015-2016. Int J Pediatr Adolesc Med. 2017;4(3):91-4.

Jenahi EK, Mohamed S, Bella H. Prevalence of attention deficit hyperactivity symptoms in female schoolchildren in Saudi Arabia. Ann Saud Med. 2012;32(5):462-8.

Taleb RF, Aesha. A descriptive study of attention deficit hyperactivity disorder in Sabia City, Saudi Arabia. Int J Cur Res Rev. 2013;5(11).

AlZaben FN, Sehlo MG, Alghamdi WA, Tayeb HO, Khalifa DA, Mira AT, et al. Prevalence of attention deficit hyperactivity disorder and comorbid psychiatric and behavioral problems among primary school students in western Saudi Arabia. Saudi Med J. 2018;39(1):52-8.

Alqahtani MM. Attention-deficit hyperactive disorder in school-aged children in Saudi Arabia. Eur J Pediatrics. 2010;169(9):1113-7.

Al Hamed JH, Taha AZ, Sabra AA, Bella H. Attention Deficit Hyperactivity Disorder (ADHD) among Male Primary School Children in Dammam, Saudi Arabia: Prevalence and Associated Factors. J Egypt Public Health Assoc. 2008;83(3-4):165-82.

Al Daajani MM, Al-Habib DM, Ibrahim MH, Al Shewear NA, Fagihi YM, Alzaher AA, Alfaleh AF, Alabdulkareem KI. Prevalence of Health Problems Targeted by the National School-Based Screening Program among Primary School Students in Saudi Arabia, 2019. Healthcare (Basel). 2021;9(10):1310.

Alrahili N, Aldakheel AA, Alubied A, Almalki A. Prevalence of adult attention deficit hyperactivity disorder among medical students in Riyadh City. Int J Med Dev Ctries. 2019;3:246-51.

Al Asqah MI, Al Orainey AI, Shukr MA, Al Oraini HM, Al Turki YA. The prevalence of internet gaming disorder among medical students at King Saud University, Riyadh, Saudi Arabia. A cross-sectional study. Saudi Med J. 2020;41(12):1359-63.

AlHadi AN, Aldussary DM, Abanumy JA, Alghamdi MA, Alsahli NA, Alghamdi SA. The Prevalence of Attention Deficit Hyperactivity Disorder, Internet Gaming Disorder, and their Association among Adults in Saudi Arabia: A Cross-Sectional Study. 2021.

Al Daajani MM, Al-Habib DM, Ibrahim MH, et al. Prevalence of Health Problems Targeted by the National School-Based Screening Program among Primary School Students in Saudi Arabia, 2019. Healthcare (Basel). Sep 30 2021;9(10).

Adewuya AO, Famuyiwa OO. Attention deficit hyperactivity disorder among Nigerian primary school children: prevalence and co-morbid conditions. Eur Child Adolesc Psychiatry. 2007;16(1):10-5.

Bener A, Al Qahtani R, Teebi AS, Bessisso M. The prevalence of attention deficit hyperactivity symptoms in schoolchildren in a highly consanguineous community. Med Principles Practice. 2008;17(6):440-6.

Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942-8.

Hinshaw SP, Scheffler RM, Fulton BD, Aase H, Banaschewski T, Cheng W, Mattos P, Holte A, Levy F, Sadeh A, Sergeant JA, Taylor E, Weiss MD. International variation in treatment procedures for ADHD: social context and recent trends. Psychiatr Serv. 2011;62(5):459-64.

Holmberg K, Lundholm C, Anckarsäter H, Larsson H, Almqvist C. Impact of asthma medication and familial factors on the association between childhood asthma and attention-deficit/hyperactivity disorder: a combined twin- and register-based study: Epidemiology of Allergic Disease. Clin Exp Allerg. 2015;45(5):964-73.

Bener A, Kamal M, Bener H, Bhugra D. Higher prevalence of iron deficiency as strong predictor of attention deficit hyperactivity disorder in children. Ann Med Health Sci Res. 2014;4(3):S291-7.

Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry. 2000;157(5):816-8.

Gephart HR. Attention-deficit/hyperactivity disorder: Diagnosis and treatment through adulthood. Primary Psychiatry. 2003;10(4):27-8.

Corkum P, Bessey M, McGonnell M, Dorbeck A. Barriers to evidence-based treatment for children with attention-deficit/hyperactivity disorder. Attention Deficit Hyperactivity Disord. 2015;7(1):49-74.

Ghossoub E, Ghandour LA, Halabi F, Zeinoun P, Shehab AAS, Maalouf FT. Prevalence and correlates of ADHD among adolescents in a Beirut community sample: results from the BEI-PSY Study. Child Adolesc Psychiatry Ment Health. 2017;11(1):20.

St Sauver JL, Barbaresi WJ, Katusic SK, Colligan RC, Weaver AL, Jacobsen SJ. Early life risk factors for attention-deficit/hyperactivity disorder: a population-based cohort study. Mayo Clin Proceed. 2004;79(9):1124-31.

Tapert SF, Baratta MV, Abrantes AM, Brown SA. Attention dysfunction predicts substance involvement in community youths. J Am Acad Child Adolesc Psychiatry. 2002;41(6):680-6.

Tercyak KP, Lerman C, Audrain J. Association of attention-deficit/hyperactivity disorder symptoms with levels of cigarette smoking in a community sample of adolescents. J Am Acad Child Adolesc Psychiatry. 2002;41(7):799-805.

Frick PJ, Dickens C. Current perspectives on conduct disorder. Curr Psychiatry Rep. 2006;8(1):59-72.

Banerjee TD, Middleton F, Faraone SV. Environmental risk factors for attention-deficit hyperactivity disorder. Acta Paediatrica (Oslo, Norway : 1992). 2007;96(9):1269-74.

Cénat JM, Blais-Rochette C, Morse C, et al. Prevalence and Risk Factors Associated With Attention-Deficit/Hyperactivity Disorder Among US Black Individuals: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2021;78(1):21-8.

Kalil KM, Gregory J, Makled M. Systematic review of risk factors associated with attention deficit hyperactivity disorder. J Res Clin Med. 2014;2(4):159-66.

Gillberg C, Gillberg IC, Rasmussen P, Kadesjö B, Söderström H, Råstam M, Johnson M, Rothenberger A, Niklasson L. Co-existing disorders in ADHD - implications for diagnosis and intervention. Eur Child Adolesc Psychiatry. 2004;13(1):I80-92.

Silva D, Houghton S, Hagemann E, Bower C. Comorbidities of attention deficit hyperactivity disorder: pregnancy risk factors and parent mental health. Comm Ment Health J. 2015;51(6):738-45.

Freitag CM, Hänig S, Schneider A, Seitz C, Palmason H, Retz W, et al. Biological and psychosocial environmental risk factors influence symptom severity and psychiatric comorbidity in children with ADHD. J Neural Transmission (Vienna, Austria: 1996). 2012;119(1):81-94.




How to Cite

Almojarthe, B. M. (2023). Prevalence of attention deficit hyperactivity disorder in the Arab Gulf countries: systematic review and meta-analysis. International Journal Of Community Medicine And Public Health, 10(2), 833–841.