Screening of Attention-Deficit Hyperactivity Disorder and its associated factors among medical university students in Lebanon: A multicenter cross-sectional study

Attention-Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder that may adversely affect academic performance and well-being. Data on ADHD among Lebanese medical students are limited. This study assessed the prevalence of probable ADHD symptoms and associated factors among medical students in Lebanon. A multicenter cross-sectional study was conducted among medical students from six Lebanese universities. Participants completed an online questionnaire including the Adult ADHD Self-Report Scale (ASRS v1.1), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Factors associated with ADHD screening scores were identified using multivariable linear regression. A total of 306 medical students participated; 60.8% were female, and the mean age was 21.9 ± 2.1 years. Overall, 93 students screened positive for probable ADHD symptoms, corresponding to a prevalence of 30.4% (95% CI: 25.5%-35.8%). Higher ADHD screening scores were independently associated with fourth academic year (β = 0.605, 95% CI: 0.111-1.099; p = 0.017), middle socioeconomic status (β = 0.399, 95% CI: 0.022-0.777; p = 0.038), comorbidities (β = 0.624, 95% CI: 0.082-1.167; p = 0.024), birth complications (β = 0.888, 95% CI: 0.311-1.466; p = 0.003), smoking (β = 1.054, 95% CI: 0.415-1.692; p = 0.001), higher PHQ-9 scores (β = 0.089, 95% CI: 0.042-0.136; p < 0.001), and poorer sleep quality (PSQI score; β = 0.093, 95% CI: 0.029-0.157; p = 0.005). Nearly one-third of Lebanese medical students screened positive for probable ADHD symptoms. These findings suggest that ADHD symptoms may coexist with modifiable psychological and lifestyle factors, highlighting the need for integrated screening and support services within medical schools. Future longitudinal studies using clinical diagnostic assessments are warranted to clarify causal relationships and confirm ADHD diagnoses.