Prevalence of attention-deficit hyperactivity disorder in India: A systematic review and meta-analysis

Abstract

Attention-deficit hyperactivity disorder (ADHD) is one of the popular neurological developmental disorders among children, adolescents, and even in adults. It is manifested by difficulty in attention, hyperactivity, and impulsiveness. ADHD and impulsivity can hinder in the school life, attaining goals, different abilities, and competitions of the student. There is ample literature reporting the prevalence of ADHD in the most part of the world. However, the prevalence of ADHD is not clearly understood in India. Many studies have been conducted in India to estimate the prevalence of ADHD in different parts of the country, but no attempt has yet been done to draw a conclusion on the pooled prevalence of ADHD in India. The goal of this study is to review all the available observational studies on the estimation of prevalence of ADHD among children and adolescents from different parts of the country to calculate the pooled prevalence of ADHD in India (among children and adolescents). The search also was limited to studies conducted from 2009 to 2019. All the epidemiological survey related to ADHD prevalence was included in the study after considering the inclusion criteria. Articles were reviewed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Each individual study was assessed for risk bias using the “Quality assessment checklist for prevalence studies” extracted from Hoy et al. Pooled Prevalence estimates was calculated with random effect model. The point prevalence of ADHD among children and adolescents in the included studies ranges from 1.30% to 28.9%. The pooled prevalence of ADHD among children and adolescents is 7.1% (95% confidence interval [CI]: 5.1%–9.8%). The summarized prevalence of ADHD is 9.40% (95% CI 6.50%–13.30%; I2 = 96.07% P < 0.001) among male children and 5.20% (95% CI 3.40%–7.70%; I2 = 94.17% P < 0.001) among female children with a range of 7.6%–15% in 8–15 years of children. The prevalence of ADHD among children in India is consistent with the worldwide prevalence. According to the ADHD Institute, Japan the world prevalence of ADHD ranges from 0.1% to 8.1%. This explains that ADHD affects quite a large number of children in India. As India is known for stigma related to mental disorders understanding the prevalence of ADHD in Indian Population helps to gain an insight into morbidity burden of the country and helps the parents and teachers to take care of the persons suffering from ADHD.