Regional and national burden of attention-deficit hyperactivity disorder in Asia, 1990-2023: a Global Burden of Disease Study 2023

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) represents a substantial lifelong economic and functional burden, yet comprehensive assessments of its burden in Asia have been limited. In this study, we quantified the burden of ADHD across Asia at both regional and national levels. METHODS: We estimated the burden of ADHD across 34 Asian countries from 1990 to 2023 using data from the Global Burden of Disease Study 2023. ADHD was defined as the presence of six or more inattention or hyperactivity-impulsivity symptoms lasting ≥ 6 months. Burden was assessed using age-standardized years lived with disability (YLD) rates with 95% uncertainty intervals (UIs), stratified by age and sex, and compared across pre- and post-pandemic periods. RESULTS: The burden of ADHD in Asia remained largely concentrated in childhood and adolescence, with comparatively modest temporal changes in age-standardized YLD rates from 1990 to 2023. East Asia showed the largest increase over this period and had the highest age-standardized YLD rate in 2023, at 82.20 (95% UI: 46.77-122.88) per 100,000 population. Across all Asian regions, age-specific YLD rates peaked among individuals aged 10 to 14 years, reaching 213.03 (95% UI: 113.82-322.27) per 100,000 population in East Asia, and declined progressively thereafter. Males consistently had higher YLD rates than females across regions and age groups. During the COVID-19 pandemic, the ADHD burden increased in most Asian countries, with particularly pronounced increases in the high-income Asia Pacific region. In addition, the ADHD burden was positively correlated with a higher Socio-demographic Index. CONCLUSIONS: Our findings define males and children aged 10-14 years as priority groups for early ADHD detection and intervention. Moreover, we provide critical evidence to guide targeted ADHD prevention and management strategies across Asia.