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ORIGINAL RESEARCH article

Front. Psychiatry

Sec. ADHD

Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1646618

Critical Appraisal of Studies Evaluating Prevalence of Attention Deficit Hyperactivity Disorder

Provisionally accepted
MIchelle TivadarMIchelle Tivadar1,2Sara PopitSara Popit1,3Matej StuhecMatej Stuhec4*Igor LocatelliIgor Locatelli1
  • 1University of Ljubljana, Faculty of Pharmacy, Ljubljana, Slovenia, Ljubljana, Slovenia
  • 2Lekarna Novak, Novo mesto, SLovenia, Novo mesto, Slovenia
  • 3Pomurske lekarne, Murska Sobota, Slovenia., Murska Sobota, Slovenia
  • 4Faculty of Medicine, University of Maribor, Maribor, Slovenia

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Introduction: Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting an estimated 5–7% of children and adolescents and 2–5% of adults. However, prevalence rates in published studies vary widely, largely due to methodological differences. High-quality, accurate, prevalence data are essential for clinical decision-making and policymaking. However, these data have not been consistently documented in previous meta-analyses and systematic reviews. Aim: To assess the methodological quality of studies reporting ADHD prevalence using the relevant critical appraisal tool. Methods: Our previously published systematic review identified 103 studies reporting clinically confirmed ADHD prevalence. The studies were grouped by type and age of subjects, and 101 studies were evaluated for risk of bias using an adapted Joanna Briggs Institute (JBI) critical appraisal tool modelled on the Cochrane Risk of Bias-2 (RoB2) method. Results: The Joanna Briggs Institute (JBI) critical appraisal tool was found to be the most suitable for evaluating prevalence studies. Of the studies reviewed, 62 (61.4%) were at high risk of bias, and only seven (6.9%) had a low risk. Although one-and two-stage clinical study designs are of a higher quality, they are still often highly susceptible to bias. Conclusion: The methodological quality of most ADHD prevalence studies is low. Systematic reviews must include critical appraisal to ensure the reliability of synthesised data. Accurate prevalence estimates are urgently needed in order to improve our understanding of the disease burden and enhance patient management.

Keywords: Attention Deficit Hyperactivity Disorder, Epidemiology, Prevalence, Systematic review, Methodological quality, Critical appraisal tool

Received: 13 Jun 2025; Accepted: 15 Sep 2025.

Copyright: © 2025 Tivadar, Popit, Stuhec and Locatelli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Matej Stuhec, matejstuhec@gmail.com

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material