Prevalence of adult ADHD: A cross-sectional analysis using the self-report scale (ASRS) among undergraduate and post-graduate medical students in Peshawar, Pakistan.

Abstract

Objective: To determine the prevalence of adult ADHD among undergraduate and postgraduate medical students in Pakistan, explore gender and academic-level differences, and assess the relationship between symptom severity and ADHD medication use. Study Design: Descriptive Cross-sectional study. Setting: Northwest School of Medicine, Peshawar. Period: May 2023 to September 2023. Methods: Was conducted among 394 medical students (227 undergraduates, 167 postgraduates) in Peshawar, Pakistan. Participants completed the Adult ADHD Self-Report Scale (ASRS). Using stratified random sampling from medical colleges and teaching hospitals in Peshawar. The ASRS (Urdu-translated and pre-validated version; Cronbach’s α = 0.84) was employed. Data were analyzed using SPSS 27, with chi-square tests used to evaluate associations among ADHD severity, gender, academic status, and medication use. Results: Overall, 53.3% of students screened positive for mild ADHD and 18.8% for severe ADHD. Females reported higher symptom severity than males (p = 0.039 (Cramér’s V = 0.13, 95% CI 0.04–0.23)”), and undergraduates more than postgraduates (p = 0.003 (Cramér’s V = 0.17, 95% CI 0.07–0.27)). Common symptoms included procrastination (78.2%), organizational difficulties (73.4%), and restlessness (77.9%). Students using ADHD medication (primarily modafinil) had a significantly lower prevalence of severe ADHD (37.83%) compared to those unmedicated (62.17%; p < 0.001), though side effects such as insomnia (62%) and anxiety (38%) were frequent. Conclusion: ADHD is prevalent among Pakistani medical students, especially females and undergraduates. While medication appears to reduce symptom severity, adverse effects may limit adherence. Early identification and targeted academic support are critical for improving outcomes in this population.