Data on the incidence, prevalence, and disability-adjusted life years (DALYs) of ADHD in children and adolescents from 1990 to 2021 were obtained from the Global Burden of Disease (GBD) 2021 database. Joinpoint regression models were used to analyze the annual percentage change in disease burden, and socio-demographic index (SDI) was incorporated to analyze health inequality and frontier trends.

From 1990 to 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALYs rate (ASDR) for ADHD in China showed an upward trend, while they declined globally. China's ASIR increased from 280.61/100 000 to 356.80/100 000, ASPR rose from 3079.72/100 000 to 3653.25/100 000, and ASDR went up from 37.85/100 000 to 45.00/100 000.Globally, ASIR declined from 166.40/100 000 to 159.93/100 000, ASPR decreased from 1900.79/100 000 to 1730.67/100 000, and ASDR dropped from 23.28/100 000 to 21.22/100 000. ADHD disease burden was highest among the 5-14-year-old population, with males significantly higher than females. SDI showed a positive correlation with ADHD disease burden, and inequality among different socio-economic groups has somewhat alleviated, though there remains room for improvement in some countries.

The increasing ADHD disease burden in China contrasts with the global trend, highlighting the need for enhanced early screening interventions and age- and gender-sensitive strategies. High SDI countries should also focus on the impact of social and psychological factors, optimize diagnostic and treatment pathways, and promote health equity.