A BSTRACT Background: Attention-deficit/hyperactivity disorder (ADHD) remains underdiagnosed and undertreated globally. Primary healthcare physicians (PHCPs) serving as critical gatekeepers for early detection and management. This study assessed the knowledge, attitudes, practices, and barriers among PHCPs regarding ADHD diagnosis and management in Saudi Arabia. Methods: This cross-sectional study was conducted among primary healthcare physicians in the Riyadh Second Health Cluster from October to December 2024. Data were collected using a validated self-administered questionnaire. The instrument assessed demographic characteristics, ADHD knowledge (12 items), attitudes (four items), practice behaviors, confidence levels, and perceived barriers. Statistical analysis included descriptive statistics, Analysis of Variance (ANOVA), and Pearson correlations. Results: Of the 325 participating PHCPs, 181 (55.7%) were male and 144 (44.3%) female, with 165 (50.8%) aged 20-29 years and 210 (64.6%) with ≤5 years of experience. The mean knowledge score was 7.92 ± 1.84 of 12, with 135 (41.5%) demonstrating good knowledge. However, only 84 (26.0%) had diagnosed ADHD cases in the past year, 19 (6.0%) had prescribed treatment, and 175 (54.0%) referred patients to specialists. The mean confidence level was moderate (2.97 ± 0.91). High barriers were reported by 194 (59.7%) physicians, with predominantly limited training (78.2%), diagnostic complexity (72.0%), and limited resources (61.5%). Seminar attendance significantly improved knowledge scores (8.11 ± 1.84 vs. 7.54 ± 1.80, P = 0.008). Significant correlations emerged between knowledge-attitude (r = 0.156, P < 0.01), diagnosis-referral behavior (r = 0.516, P < 0.001), and confidence-diagnostic experience (r = 0.258, P < 0.001). Female physicians reported significantly higher barrier scores than men (4.08 ± 1.68 vs. 3.70 ± 1.58, P = 0.034). Conclusion: Despite moderate ADHD knowledge among primary care physicians, significant knowledge gaps existed, with low diagnostic engagement driven by training deficits and systemic barriers. Targeted educational interventions and system-level support are essential for enhancing the primary care ADHD capacity in Saudi Arabia.
Alkathiry et al. (Sun,) studied this question.