Diagnosis and Prescribing Patterns of Adult Attention-Deficit Hyperactivity Disorder in a Tertiary Care Hospital in the United Arab Emirates: A Retrospective Study

Background: Adult attention-deficit hyperactivity disorder (ADHD) is increasingly recognized; however, evidence describing diagnostic pathways, comorbidity burden, and prescribing practices in adult care remains limited. Purpose: To characterize diagnostic patterns, psychiatric comorbidities, and prescribing ‎practices for adult ADHD across outpatient specialties in a tertiary care setting in the United ‎Arab Emirates.‎. Methods: A retrospective chart review was conducted for adults aged ≥ 18 years diagnosed with attention-deficit hyperactivity disorder (ADHD) at a tertiary care hospital in Dubai, United Arab Emirates, between May 2023 and August 2024. Cases were identified using the ICD-10 code F90.x. Demographic characteristics, diagnosing specialty, ADHD diagnostic hierarchy and subtype, psychiatric comorbidities, and prescription data were extracted from electronic health records. Prescription data included ADHD-specific pharmacotherapy and medications for associated psychiatric or medical comorbidities. Descriptive statistics summarized diagnostic and prescribing patterns. One-way analysis of variance and chi-square tests examined differences in diagnostic yield across outpatient specialties and associations between diagnosis type, comorbidity presence, and prescribing patterns, with statistical significance set at P < 0.05. Results: A total of 157 adult ADHD cases were identified. Psychiatry accounted for most diagnoses (60.5%), followed by family medicine (28.0%), neurology (10.2%), and internal medicine (1.3%). Diagnostic yield differed significantly across specialties (F = 32.96, P < 0.001). ADHD was documented as a secondary diagnosis in 60.5% of cases, most commonly with anxiety and depressive disorders, with comorbidity presence significantly associated with diagnosis type (χ 2 = 157.00, P < 0.001). Inattentive and unspecified subtypes predominated (χ 2 = 85.82, P < 0.001). Among 509 prescribed medications, methylphenidate accounted for 46% and was prescribed significantly more frequently than other agents (χ 2 = 314.21, P < 0.001). Conclusion: Adult ADHD was often diagnosed with psychiatric comorbidity, mainly in psychiatric services, with marked variation across specialties, highlighting the need for standardized diagnostic pathways and UAE-specific clinical guidance. Keywords: neurodevelopmental disorder, psychiatry, adult ADHD, inattention, impulsivity, central nervous system stimulants