How Common Is ADHD in the Middle East and North Africa?

What you need to know

• ADHD affects about 10.3% of people in the Middle East and North Africa region
• ADHD is more common in males (11.1%) than females (7%)
• The inattentive subtype of ADHD is most prevalent, followed by hyperactive/impulsive and combined types
• ADHD rates vary significantly between countries in the region, from 1.3% in Yemen to 22.2% in Iran

Understanding ADHD Prevalence in the MENA Region

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects both children and adults. People with ADHD may have difficulty paying attention, controlling impulsive behaviors, or be overly active. While ADHD is recognized globally, its prevalence can vary between different regions and populations.

A team of researchers recently conducted a comprehensive review to understand how common ADHD is in the Middle East and North Africa (MENA) region. This area includes countries like Egypt, Iran, Saudi Arabia, and others. The study aimed to provide a clearer picture of ADHD rates across different age groups and countries in this part of the world.

Overall ADHD Prevalence

The researchers analyzed data from 63 studies, involving a total of 849,902 participants from 15 MENA countries. They found that the overall prevalence of ADHD in the region was 10.3%. This means that about 1 in 10 people in the MENA region may have ADHD.

This rate is somewhat higher than global estimates, which typically range from 5% to 7%. The higher prevalence in the MENA region could be due to various factors, including:

• Differences in diagnostic criteria and assessment methods
• Cultural factors that may influence how ADHD symptoms are perceived and reported
• Environmental or genetic factors specific to the region

It’s important to note that having a higher prevalence doesn’t necessarily mean ADHD is more common in this region. It could also reflect differences in how ADHD is identified and diagnosed.

Age Differences in ADHD Prevalence

The study found some interesting differences in ADHD rates between children/adolescents and adults:

• In children and adolescents (ages 3-18): 10.1%
• In adults: 13.5%

The higher rate in adults was unexpected, as ADHD symptoms often decrease with age. This finding could suggest that ADHD in adults may be under-recognized in other parts of the world. It also highlights the importance of considering ADHD as a lifelong condition that can continue to affect people into adulthood.

Gender Differences

Consistent with other research on ADHD, this study found that males were more likely to have ADHD than females:

• Males: 11.1%
• Females: 7%

This gender difference was seen in both children/adolescents and adults. However, it’s worth noting that ADHD in females is often underdiagnosed, as they may show different symptoms than males. Females with ADHD may be more likely to have inattentive symptoms rather than hyperactive ones, which can be less noticeable.

ADHD Subtypes

ADHD is typically categorized into three subtypes:

1. Inattentive type: Difficulty focusing and paying attention
2. Hyperactive/impulsive type: Excessive activity and impulsive behavior
3. Combined type: A mix of inattentive and hyperactive/impulsive symptoms

The study found that among people with ADHD in the MENA region:

• 46.7% had the inattentive type
• 33.7% had the hyperactive/impulsive type
• 20.6% had the combined type

The higher prevalence of the inattentive type is notable. This subtype can sometimes be harder to recognize, especially in adults, as the symptoms may be less outwardly visible than hyperactivity.

Variations Between Countries

One of the most striking findings of this study was the large variation in ADHD prevalence between different MENA countries:

• Highest: Iran (22.2%)
• Lowest: Yemen (1.3%)

Other notable rates included:

• Tunisia: 14.3%
• Egypt, Iraq, Israel, Jordan, Palestine: Around 12%
• Qatar and United Arab Emirates: 9.2%
• Saudi Arabia: 3.2%

These differences could be due to various factors, including:

• Variations in diagnostic practices and access to mental health services
• Cultural differences in how ADHD symptoms are perceived and reported
• Genetic or environmental factors specific to certain populations
• Differences in study methodologies between countries

It’s important to interpret these country-specific rates cautiously, as they may not always reflect true differences in ADHD prevalence. Instead, they might indicate variations in how ADHD is recognized and diagnosed in different healthcare systems and cultural contexts.

Implications for ADHD Care in the MENA Region

The findings of this study have several important implications for ADHD care in the Middle East and North Africa:

1. Need for increased awareness: With ADHD affecting about 1 in 10 people in the region, there’s a need for greater public awareness about the condition. This could help reduce stigma and encourage people to seek help when needed.

2. Importance of adult ADHD recognition: The high prevalence in adults suggests that healthcare systems in the region should be prepared to diagnose and treat ADHD across the lifespan, not just in children.

3. Gender-sensitive approaches: While ADHD is more common in males, it’s crucial not to overlook the condition in females. Healthcare providers should be aware of how ADHD may present differently in females.

4. Tailored interventions: The high prevalence of the inattentive subtype suggests that interventions focused on improving attention and concentration may be particularly beneficial in this region.

5. Country-specific strategies: Given the large variations between countries, ADHD strategies may need to be tailored to the specific context of each country in the MENA region.

Conclusions

• ADHD is a significant public health concern in the Middle East and North Africa, affecting about 10% of the population
• ADHD rates vary widely between countries in the region, highlighting the need for country-specific approaches
• The condition affects both children and adults, emphasizing the importance of lifelong ADHD care
• More research is needed to understand the factors contributing to ADHD prevalence in the MENA region and to develop effective, culturally-appropriate interventions