{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T16:10:33Z","timestamp":1774887033506,"version":"3.50.1"},"reference-count":27,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and may persist into adulthood, characterized by inattention, impulsivity, and hyperactivity leading to functional impairment. The global prevalence in children and adolescents ranges from 5\u20137%, yet data from the Eastern Province of Saudi Arabia remain limited. This study determined the prevalence of hyperactive\/impulsive and inattentive symptoms among children and adolescents aged 4\u201318 years and identified associated factors. A cross-sectional study was conducted across major cities using validated Arabic versions of the SNAP-IV and NICHQ Vanderbilt Assessment Scale distributed online. The survey assessed ADHD symptoms, oppositional defiant disorder, conduct disorder, anxiety\/depression, functional impairment, and prenatal and perinatal risk factors, with DSM-based scoring and multivariable logistic regression to identify predictors. Among 920 participants (mean age 10.7 years; 52.9% boys), 12.7% met criteria for ADHD. The inattentive subtype was most common, followed by combined and hyperactive\/impulsive types. Affected children and adolescents showed academic and interpersonal difficulties. Significant predictors included younger age, birth weight &lt;1.5 kg, psychiatric history, previous ADHD diagnosis, and family history of psychiatric or neurological disorders. ADHD symptoms were relatively common and associated with functional impairment and identifiable developmental and familial risk factors.<\/jats:p>","DOI":"10.3390\/ijerph23040436","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T15:20:47Z","timestamp":1774884047000},"page":"436","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of ADHD Among Saudi Children and Adolescents"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3411-819X","authenticated-orcid":false,"given":"Faisal O.","family":"AlQurashi","sequence":"first","affiliation":[{"name":"Department of Pediatrics, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 34224, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6739-1858","authenticated-orcid":false,"given":"Renad A.","family":"Alrasan","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34224, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reem N.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 34224, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nora M.","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 34224, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alea A.","family":"Mohammedhussain","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. Sulaiman Al Habib Hospital, Al Khobar 34423, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nersyan N.","family":"Sharbini","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34224, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bayan M.","family":"Almanasif","sequence":"additional","affiliation":[{"name":"Nursing Department, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 34224, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025, November 16). World Mental Health Report: Transforming Mental Health for All. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240049338."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/jcpp.12381","article-title":"Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents","volume":"56","author":"Polanczyk","year":"2015","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e20192528","DOI":"10.1542\/peds.2019-2528","article-title":"Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit\/Hyperactivity Disorder in Children and Adolescents","volume":"144","author":"Wolraich","year":"2019","journal-title":"Pediatrics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.jad.2023.07.071","article-title":"The global prevalence of attention deficit hyperactivity disorder in children and adolescents: An umbrella review of meta-analyses","volume":"339","author":"Ayano","year":"2023","journal-title":"J. Affect. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1080\/15374416.2017.1417860","article-title":"Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among, U.S. Children and Adolescents, 2016","volume":"47","author":"Danielson","year":"2018","journal-title":"J. Clin. Child Adolesc. Psychol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"52","DOI":"10.15537\/smj.2018.1.21288","article-title":"Prevalence of attention deficit hyperactivity disorder and comorbid psychiatric and behavioral problems among primary school students in western Saudi Arabia","volume":"39","author":"AlZaben","year":"2018","journal-title":"Saudi Med. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"544","DOI":"10.4103\/aam.aam_163_22","article-title":"Estimated prevalence study of attention-deficit\/hyperactivity disorder among eastern province children in the Kingdom of Saudi Arabia","volume":"22","author":"AlShamrani","year":"2023","journal-title":"Ann. Afr. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"462","DOI":"10.5144\/0256-4947.2012.462","article-title":"Prevalence of attention deficit hyperactivity symptoms in female schoolchildren in Saudi Arabia","volume":"32","author":"Jenahi","year":"2012","journal-title":"Ann. Saudi Med."},{"key":"ref_9","unstructured":"Saudi ADHD Society (2026, February 24). Arabic Vanderbilt Parent Informant\u2014Evidence-Based Clinical Practice Guideline for Management of ADHD in Saudi Arabia. Available online: https:\/\/cpg.adhd.org.sa\/en\/guideline\/rating-scales\/vanderbilt-parent\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e078849","DOI":"10.1136\/bmjopen-2023-078849","article-title":"Prevalence of attention-deficit hyperactivity disorder in children, adolescents and adults in the Middle East and North Africa region: A systematic review and meta-analysis","volume":"14","author":"Etoom","year":"2024","journal-title":"BMJ Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1093\/jpepsy\/jsl054","article-title":"Academic and educational outcomes of children with ADHD","volume":"32","author":"Loe","year":"2007","journal-title":"J. Pediatr. Psychol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.jaac.2018.11.014","article-title":"Attention-Deficit\/Hyperactivity Disorder, School Performance, and Effect of Medication","volume":"58","author":"Jangmo","year":"2019","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1136\/archdischild-2015-309581","article-title":"Early and long-term outcome of infants born extremely preterm","volume":"102","author":"Johnson","year":"2017","journal-title":"Arch. Dis. Child."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1038\/s41380-018-0070-0","article-title":"Genetics of attention deficit hyperactivity disorder","volume":"24","author":"Faraone","year":"2019","journal-title":"Mol. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"105050","DOI":"10.1016\/j.neubiorev.2023.105050","article-title":"Meta-analysis of personal and familial co-occurrence of Attention Deficit\/Hyperactivity Disorder and Bipolar Disorder","volume":"146","author":"Khoury","year":"2023","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"AlQurashi, F.O., Almensif, F.S., Alkhabbaz, F.H., Alkhawahir, K.Y., and Abalkhail, D. (2025). Screen Time Matters: Exploring the Behavioral Effects of Devices on Saudi Children. Int. J. Environ. Res. Public Health, 22.","DOI":"10.3390\/ijerph22050741"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1038\/s41398-025-03672-1","article-title":"Association of screen time with attention-deficit\/hyperactivity disorder symptoms and their development: The mediating role of brain structure","volume":"15","author":"Shou","year":"2025","journal-title":"Transl. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"126","DOI":"10.4103\/sjmms.sjmms_528_22","article-title":"Prevalence and Risk Factors of Attention Deficit-Hyperactivity Disorder in the Saudi Population: A Systematic Review and Meta-analysis","volume":"11","author":"Aljadani","year":"2023","journal-title":"Saudi J. Med. Med. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Skogli, E.W., Teicher, M.H., Andersen, P.N., Hovik, K.T., and \u00d8ie, M. (2013). ADHD in girls and boys--gender differences in co-existing symptoms and executive function measures. BMC Psychiatry, 13.","DOI":"10.1186\/1471-244X-13-298"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Ni, M., Li, L., Li, W., Zhang, Q., Zhao, J., Shen, Q., Yao, D., Wang, T., Li, B., and Ding, X. (2023). Examining the relationship between birth weight and attention-deficit hyperactivity disorder diagnosis. Front. Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1074783"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1111\/jcpp.12168","article-title":"Associations between birth weight and attention-deficit\/hyperactivity disorder symptom severity: Indirect effects via primary neuropsychological functions","volume":"55","author":"Hatch","year":"2014","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Huang, X., Li, H.Q., Simpson, A., Xu, J.J., Tang, W.J., and Li, Y.Y. (2023). Differences among fathers, mothers, and teachers in symptom assessment of ADHD patients. Front. Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1029672"},{"key":"ref_23","first-page":"195","article-title":"A Comparison between School and Home Rating Scales and Reliability-Validity of the Scales-the Scales for Diagnosing Attention-Deficit\/Hyperactivity Disorder","volume":"51","author":"Turan","year":"2014","journal-title":"Noro Psikiyatr. Ars."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"834","DOI":"10.26719\/emhj.20.032","article-title":"Differences in identification of attention deficit hyperactivity disorder in children between teachers and parents","volume":"26","author":"Nafi","year":"2020","journal-title":"East Mediterr. Health J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/S2215-0366(24)00010-5","article-title":"Why are females less likely to be diagnosed with ADHD in childhood than males?","volume":"11","author":"Martin","year":"2024","journal-title":"Lancet Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s00787-017-1029-4","article-title":"Characteristics of undiagnosed children with parent-reported ADHD behaviour","volume":"27","author":"Madsen","year":"2018","journal-title":"Eur. Child. Adolesc. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"103205","DOI":"10.1016\/j.ajp.2022.103205","article-title":"Gender-based differences in prevalence and effects of ADHD in adults: A systematic review","volume":"75","author":"Faheem","year":"2022","journal-title":"Asian J. Psychiatry"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/4\/436\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T15:22:17Z","timestamp":1774884137000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/4\/436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["ijerph23040436"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23040436","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]}}}