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Incidence, prevalence, and global burden of ADHD from 1990 to 2019 across 204 countries: data, with critical re-analysis, from the Global Burden of Disease study

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Cortese, Samuele, Song, Minjin, Farhat, Luis C., Yon, Dong Keon, Lee, Seung Won, Kim, Min Seo, Park, Seoyeon, Oh, Jae Won, Lee, San, Cheon, Keun-Ah, Smith, Lee, Gosling, Corentin J., Polanczyk, Guilherme V., Larsson, Henrik, Rohde, Luis A., Faraone, Stephen V., Koyanagi, Ai, Dragioti, Elena, Radua, Joaquim, Carvalho, Andre F., Il Shin, Jae, Solmi, Marco·2023·Molecular Psychiatry

DOI 10.1038/s41380-023-02228-3

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Abstract

Data on incidence, prevalence and burden of ADHD are crucial for clinicians, patients, and stakeholders. We present the incidence, prevalence, and burden of ADHD globally and across countries from 1990 to 2019 from the Global Burden of Disease (GBD) study. We also: (1) calculated the ADHD prevalence based on data actually collected as opposed to the prevalence estimated by the GBD with data imputation for countries without prevalence data; (2) discussed the GBD estimated ADHD burden in the light of recent meta-analytic evidence on ADHD-related mortality. In 2019, GBD estimated global age-standardized incidence and prevalence of ADHD across the lifespan at 0.061% (95%UI = 0.040–0.087) and 1.13% (95%UI = 0.831–1.494), respectively. ADHD accounted for 0.8% of the global mental disorder DALYs, with mortality set at zero by the GBD. From 1990 to 2019 there was a decrease of −8.75% in the global age-standardized prevalence and of −4.77% in the global age-standardized incidence. The largest increase in incidence, prevalence, and burden from 1990 to 2019 was observed in the USA; the largest decrease occurred in Finland. Incidence, prevalence, and DALYs remained approximately 2.5 times higher in males than females from 1990 to 2019. Incidence peaked at age 5–9 years, and prevalence and DALYs at age 10–14 years. Our re-analysis of data prior to 2013 showed a prevalence in children/adolescents two-fold higher (5.41%, 95% CI: 4.67–6.15%) compared to the corresponding GBD estimated prevalence (2.68%, 1.83–3.72%), with no significant differences between low- and middle- and high-income countries. We also found meta-analytic evidence of significantly increased ADHD-related mortality due to unnatural causes. While it provides the most detailed evidence on temporal trends, as well as on geographic and sex variations in incidence, prevalence, and burden of ADHD, the GBD may have underestimated the ADHD prevalence and burden. Given the influence of the GBD on research and policies, methodological issues should be addressed in its future editions.

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Wrigglesworth, J., Chirokoff, V., Fransquet, P., Craig, J. M., & Silk, T. J. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.10.21.681830
Cognitive control in children with ADHD and subthreshold ADHD: an eye-tracking study
Fabio, R. A., Picciotto, G., Tsoy, S. V., Vazzana, R., Fatmehsari, M. H., & Filippello, P. (2025) · Exploration of Neuroprotective Therapy · doi:10.37349/ent.2025.1004134
Food, psychobiotics and their role in mental health
Kumar, T., Bansal, U., Singh, S., & Sharma, V. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-33116-9.00014-0
Prenatal Exposure to Air Pollution and Risk for Attention-Deficit/hyperactivity Disorder in Children
Kaur, S., Canals, J., Morales‐Hidalgo, P., Guxens, M., Petricola, S., & Arija, V. (2026) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-025-01397-9
“…disorder, with symptom onset occurring before the age of 12 according to the DSM-5-TR (APA, 2022) and peaking at the ages between 5–9 years (Cortese et al., 2023), it is particularly important to explore the prenatal effects of air pollutants, as this period constitutes a critical window…”
Influential
Developmental Differences in White Matter Microarchitecture in Youth with ADHD: Longitudinal Findings from the ABCD StudyPreprint
Overholtzer, L. N., Bottenhorn, K. L., Ahmadi, H., Karalunas, S., Peterson, B. S., & Herting, M. M. (2026) · bioRxiv · doi:10.64898/2026.02.20.707054 · Cited by 1
Neurodevelopmental comorbidities in juvenile systemic autoimmune and autoinflammatory diseases
Ellul, P., & Melki, I. (2026) · Nature Reviews Rheumatology · doi:10.1038/s41584-026-01356-8
Mind the Gap! Sleep Problems in Children With ADHD—A Qualitative Analysis of Clinician Training Needs
Smith, L., Daley, D., Cortese, S., et al. (2026) · Child Care Health and Development · doi:10.1111/cch.70254
Self-citation
Steroid/thyroid hormones and inflammatory markers in adolescents with ADHD: comparisons with healthy controls and modifications by methylphenidate
Aguado-Rivas, R., Checa-Ros, A., Fernández-López, L., Tortosa-Pinto, P., Villén, R. G., Contreras‐Chova, F., Fernández-Ibáñez, A., & Molina‐Carballo, A. (2026) · Psychiatry Research · doi:10.1016/j.psychres.2026.117111
ADHD in children, adolescents, and adults: incidence, prevalence, and treatment. An analysis of routine health insurance data
Betzler, F., Knop, J., Grönig, M., Timpel, P., Višković, V., & Schöttle, D. (2026) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2026.0032 · Cited by 1
Afterword to Exploring Complex Attention Deficit Hyperactivity Disorder Through Challenging Cases
Diekroger, E. A., & Fogler, J. (2026) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000001475
Hyperactive–impulsive ADHD traits predict higher curiosity in adults: evidence from a cross-sectional study
Cunff, A. L., Russell, C., & Dommett, E. J. (2026) · BMC Psychology · doi:10.1186/s40359-026-04504-7
“Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition affecting approximately 5% of children and adolescents and 3% of adults world-wide [1, 2].”
Psychometric Evaluation of the Spanish Translation of the Disruptive-Behavior Disorder Rating Scale
Ramirez, C., Schatz, N. K., Fernandez, O., Phillips, B. M., Lonigan, C. J., Fabiano, G. A., & Gallo, R. F. (2026) · Journal of Attention Disorders · doi:10.1177/10870547261438171
Efficacy of Non-Invasive Brain Stimulation in Improving Working Memory in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Systematic Review
Vélez, W. A. Z., Ponce, J. L. A., Bailón, W. G. B., Valle, H. M. C. D., & Quirumbay, R. B. (2026) · Brain Sciences · doi:10.3390/brainsci16050480
“Globally, the prevalence of ADHD is estimated at approximately 5% [7], reaching 7.2% in children and adolescents [8].”
Influential
Plasma BDNF levels in children with ADHD before and after methylphenidate treatment
Aastrøm, M., Vangkilde, S., Lundsgaard, J., & Habekost, T. (2026) · Scandinavian Journal of Child and Adolescent Psychiatry and Psychology · doi:10.2478/sjcapp-2026-0003
“It has an estimated worldwide prevalence of around 5% among children and adolescents, with more boys being diagnosed than girls (1,2).”
The Evolving Pharmacological Landscape for Paediatric and Adult ADHD
Veronesi, G. F., Tarantino, F., Pirolo, D., & Cortese, S. (2026) · CNS Drugs · doi:10.1007/s40263-026-01299-4
“Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental condition, with an estimated prevalence of around 5% in school-aged children [1].”
Self-citation
Improving ADHD care pathways should be prioritised for children and young people
Sayal, K. S., Newlove‐Delgado, T., Prasad, V., & Thapar, A. (2026) · BMJ · doi:10.1136/bmj-2026-649169
Mortality in People with Attention-Deficit/hyperactivity Disorder (ADHD): Examining How Risk Is Embodied in a Pooling of Two Prospective Cohort StudiesPreprint
Li, H., Ford, T. J., Warrier, V., Bell, S., & Batty, G. D. (2026) · SSRN Electronic Journal · doi:10.64898/2026.06.08.26355148
Update on ADHD genetics: A practitioner's perspective: Mise à jour sur la génétique du TDAH : le point de vue d’un praticien
Schachar, R. J., Crosbie, J., Arnold, P. D., & Burton, C. L. (2026) · The Canadian Journal of Psychiatry · doi:10.1177/07067437261457230
Tool for Converting ADHD Rating Scales Scores Based on Individual Participant Data from 53 Randomized Controlled Trials of ADHD Medications
Christogiannis, C., Garcia‐Argibay, M., Tomlinson, A., Roy, S., Farhat, L. C., Veronesi, G. F., Parlatini, V., Bellato, A., Gosling, C. J., Mavridis, D., et al. (2026) · Journal of Child and Adolescent Psychopharmacology · doi:10.1177/10445463261461541
“Introduction A ttention-de ﬁ cit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder, affecting at least 5% of school-aged children and persisting in adulthood in up to 70% of cases (Cortese et al., 2023; Faraone et al., 2024).”
Self-citation
Burden of attention-deficit hyperactivity disorder in Jordan from 1990 to 2023: population-based analysis using Global Burden of Disease data
Al-Wardat, M. S., Jaber, A. F., Almhdawi, K. A., Ismael, N., Oteir, A., Abulannaz, O., Alrabbaie, H., & Khader, Y. S. (2026) · BJPsych International · doi:10.1192/bji.2026.10114
PM2.5-bound organophosphate esters and childhood attention-deficit hyperactivity disorder symptoms: A population-based study from China
Chu, C., Liu, X., Chen, Y.-X., Dong, J.-X., Zhang, Y.-T., He, W.-T., Huang, J.-W., Liang, L.-X., Zhou, Y., Amjad, M., et al. (2026) · NeuroToxicology · doi:10.1016/j.neuro.2026.103509
ADHD Individuals’ Positivity About Their Condition Varies by Their Levels of Hyperactivity/Impulsivity Versus Inattention Symptoms
Katabi, G., Huss, M., Lukito, S., Dekkers, T. J., Sonuga-Barke, E. J. S., & Shahar, N. (2026) · Journal of Attention Disorders · doi:10.1177/10870547261463814
“To date, mainstream research studies have explored the negative impacts of the condition, leading to a portrayal of it as mal-adaptive, dysfunctional, and costly (Cortese et al., 2023).”
Pre-adult attention-deficit/hyperactive disorder and later adverse health outcomes: the 1987 Finnish birth cohort study
Batty, G. D., Gissler, M., Mousavi, S. E., Warrier, V., Ford, T. J., & Keski‐Säntti, M. (2026) · Molecular Psychiatry · doi:10.1038/s41380-026-03700-6 · Cited by 1
“That the period prevalence of ADHD herein is based on administrative data may lead to some under-detection, such that studies which include sample-wide assessment of ADHD symptoms yield higher estimates [10].”
Parent and carer perspectives on behavioural sleep management strategies for children with ADHD
Hornsey, S., Rowsell, A., Hill, C. M., Cortese, S., Greenwell, K., & Muller, I. (2026) · Sleep Medicine · doi:10.1016/j.sleep.2026.109138
Self-citation
Developmental Differences in White Matter Microarchitecture in Youths With Attention-Deficit/Hyperactivity Disorder: Longitudinal Findings From the Adolescent Brain Cognitive Development Study
Overholtzer, L. N., Bottenhorn, K. L., Ahmadi, H., Karalunas, S. L., Peterson, B. S., & Herting, M. M. (2026) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2026.06.016
Exercise for core ADHD symptoms and executive functions in children and adolescents with ADHD: A network and dose–response meta-analysis
Zhang, M., He, C., Gao, X., Fan, Z., Pan, K., Huang, H., Jin, S., Wei, Y., Xu, W., Ling, J., et al. (2026) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2026.101157
Exploring zebrafish models of ADHD: A systematic review of genetic and pharmacological approaches
Sivakumar, D., Bessho, Y., & Ramli, R. B. (2026) · Behavioural Brain Research · doi:10.1016/j.bbr.2026.116393
Psychiatric diagnosis on the edge: is there evidence of benefit?
Vitiello, B., Mykletun, A., Armando, M., Davico, C., Carucci, S., Marcotulli, D., Drexl, K., Hofstad, T., Sehdev, S., & Banaschewski, T. (2026) · European Child and Adolescent Psychiatry · doi:10.1007/s00787-026-03130-3
Treatment Gaps in Paediatric ADHD Pharmacotherapy: A 10-Year Nationwide Cohort Study from HungaryPreprint
ter Nagy, P. X. E., Frigyesy, R., Mazzag, B., Stubnya, G. R., Robert, U., Fogarasi, A., & Pénzes, M. (2026) · Research Square · doi:10.21203/rs.3.rs-10411233/v1
Association between parental ADHD and adverse offspring outcomes: Evidence from a nationwide Swedish register-based study
Yao, H., Zhou, M., Brikell, I., D'Onofrio, B. M., Kuja‐Halkola, R., Li, L., Lichtenstein, P., Larsson, H., Pettersson, E., & Chang, Z. (2026) · Molecular Psychiatry · doi:10.1038/s41380-026-03770-6
Self-citation
Risk of Neurodevelopmental Disorders Following the Herpesviral Infection in Preschooler Children
Chen, L.-C., Huang, W., Hsu, J.-W., Bai, Y., Tsai, S., Su, T., Chen, T., & Chen, M. (2026) · Autism Research · doi:10.1002/aur.70336
The microbiota–gut–brain axis in neuropsychiatric disorders: Mechanisms, advances, and clinical applications
Li, T., Chang, Y., Tang, S., Chen, Y., Li, X., & Wang, Y. (2026) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2026.112062
Global burden of depression and anxiety among women of reproductive age: socioeconomic disparities and policy implications
Zheng, W., TerSangmo, Guan, Y., Xue, H., Yang, R., Yang, X., Chen, Y., Fan, L., Wang, F., & Du, W. (2026) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-026-03182-5
Association Between Attention-Deficit/Hyperactivity Disorder and Eating Disorders, Eating-Related Symptoms, and Maladaptive Eating Behaviours: Protocol for an Overview of Systematic ReviewsPreprint
Altayó, M., Philippi, R., Villalón, F., Navarro-Ovando, V., Zumaeta, A., & Decebal-Cuza, F. (2026) · Qeios · doi:10.32388/2l8mzg
Global, Regional, and National Epidemiology of Attention Deficit Hyperactivity Disorder in Children From 1990 to 2021, with Projections to 2051
Hu, J., Wang, J.-Y., Zhao, Y., Xuan, X., Ma, J.-Y., & Chen, J. (2026) · Journal of Child Neurology · doi:10.1177/08830738261464418
Quality assessment of ADHD-related short videos on Chinese social media: A cross-sectional study
Zou, P., Chen, S., Xiang, J., Zhou, W., & 杨晓蓉 (2026) · Medicine · doi:10.1097/md.0000000000050044
“[4] Therefore, it is critical to improve the prognosis of patients by accurately identifying the early symptoms of the disease and taking correct interventions.”
Candidate Clinico-Demographic Predictors or Moderators of Efficacy and Tolerability of Pharmacological Treatment in Attention-Deficit/Hyperactivity Disorder (ADHD): An Analysis of the MED-ADHD Repository of Randomised Controlled Trials
Roy, S., Veronesi, G. F., Mannarini, S., Pirolo, D., Bellato, A., Cortese, S., & Parlatini, V. (2026) · CNS Drugs · doi:10.1007/s40263-026-01323-7
“Globally, ADHD prevalence among children and adolescents is estimated at around 5%, based on data from the Global Burden of Disease database, which indicate that incidence peaks during the school-aged years [2], and at around 8% according to a recent umbrella review [3].”
Self-citation
Gut microbiota profiles and potential biomarkers in pre-pubertal females with ADHD
Bao, G., Tan, S., An, Y., & Luo, Y. (2026) · Frontiers in Microbiology · doi:10.3389/fmicb.2026.1894383
Clinical practices in ADHD management across Europe: findings from the ESCAP research academy survey
Young, H., Revet, A., Hagstrøm, J., Ateş, B. Ö., Brænden, A., Grigoriou, M., Jarvers, I., Jederström, M., Jurek, L., Kotsis, K. Τ., et al. (2026) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-026-03161-w
Self-citation
Comparison of attention-deficit/hyperactivity disorder and socioeconomic status among school-going children
Ummu Gulthoom, M., Saravanan, S., Ilangumaran, L., & Sakthi, R. (2026) · International Journal of Contemporary Pediatrics · doi:10.18203/2349-3291.ijcp20262953
Prevalence, Trends and Patterns of ADHD Medication Use Among Children, Adolescents and Young Adults in Quebec, Canada: A Repeated Cross-Sectional Population-Based Study From 2000 to 2022: Prévalence, tendances et profils d’utilisation des médicaments pour le TDAH chez les enfants, les adolescents et les jeunes adultes au Québec (Canada) : étude populationnelle transversale répétée, 2000-2022
Gignac, M., Fansi, A. K., Lunghi, C., Diallo, F., Rochette, L., Massamba, V. K., Vasiliadis, H., Rahme, E., Cortese, S., & LESAGE, A. D. (2026) · The Canadian Journal of Psychiatry · doi:10.1177/07067437261471748
Self-citation
Maternal steatotic liver disease and offspring neurodevelopmental disorders: a nationwide cohort studyPreprint
Chung, G. E., Cho, A., Kim, D. H., et al. (2026) · Research Square · doi:10.21203/rs.3.rs-10693388/v1

Authors: Cortese, S., Song, M., Farhat, L. C., Yon, D. K., Lee, S. W., Kim, M. S., Park, S., Oh, J. W., Lee, S., Cheon, K.-A., Smith, L., Gosling, C. J., Polanczyk, G. V., Larsson, H., Rohde, L. A., Faraone, S. V., Koyanagi, A., Dragioti, E., Radua, J., Carvalho, A. F., Il Shin, J., & Solmi, M.
Affiliations: University of Nottingham (GB)
Yonsei University (KR)
Kyung Hee University Medical Center (KR)
Samsung Medical Center (KR)
Anglia Ruskin University (GB)
Université Paris Cité (FR)
Universidade de São Paulo (BR)
Örebro University (SE)
SUNY Upstate Medical University (US)
Institució Catalana de Recerca i Estudis Avançats (ES)
Linköping University (SE)
Barwon Health (AU)
University of Ottawa (CA)
Corresponding author: Cortese, Samuele
ORCID: Cortese, Samuele
Farhat, Luis C.
Yon, Dong Keon
Lee, Seung Won
Kim, Min Seo
Park, Seoyeon
Oh, Jae Won
Lee, San
Cheon, Keun-Ah
Smith, Lee
Gosling, Corentin J.
Polanczyk, Guilherme V.
Larsson, Henrik
Rohde, Luis A.
Faraone, Stephen V.
Koyanagi, Ai
Dragioti, Elena
Carvalho, Andre F.
Il Shin, Jae
Solmi, Marco
Venue: Molecular Psychiatry
Publisher: Springer Science and Business Media LLC
Published: 2023-09-08
Volume: 28
Issue: 11
Pages: 4823-4830
ISSN: 1359-4184 (ISSN-L)
1476-5578
DOI: 10.1038/s41380-023-02228-3
OpenAlex: W4386545385
Semantic Scholar: f8b56283bc7766f77ad4bb43cb4db49c94786551
Cited by: 211
References: 34
Citations by year: 2026: 68 · 2025: 91 · 2024: 47 · 2023: 4
FWCI: 37.16
Type: journal article
Language: en
Open access: green
figshare.com
Licence: cc-by
www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Molecular Psychiatry (publishedVersion)
PubMed (publishedVersion)
ePrints Soton (University of Southampton) (acceptedVersion)
INRIA a CCSD electronic archive server (submittedVersion)
Figshare (submittedVersion, cc-by)
CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords: attention deficit hyperactivity disorder, incidence, prevalence, global burden of disease, disability-adjusted life years, sex differences, age distribution, temporal trends, children and adolescents, low- and middle-income countries, sex ratio bias, missing data imputation, unnatural causes of death
MeSH terms: Global Burden of Disease, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Female, Humans, Male, Global Health, Incidence, Prevalence, Quality-Adjusted Life Years

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Incidence, prevalence, and global burden of ADHD from 1990 to 2019 across 204 countries: data, with critical re-analysis, from the Global Burden of Disease study

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