Assessment of Knowledge, Attitude and Performance of Primary Healthcare Physicians in Tabuk City, Saudi Arabia regarding Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder that affects children and adolescents, often persisting into adulthood. Primary healthcare (PHC) physicians play a crucial role in the early identification, referral, and management of ADHD, yet their knowledge, attitudes, and clinical practices may vary. Aim: To assess the knowledge, attitudes, and performance of primary healthcare physicians in Tabuk City, Saudi Arabia, regarding ADHD in children and adolescents. Methods: A cross-sectional study was conducted among 181 PHC physicians in Tabuk City from April to September 2024. Data were collected using a structured, self-administered questionnaire distributed via interviews and online forms. The questionnaire included sections on sociodemographic characteristics, knowledge (12 items), attitudes, and clinical practices related to ADHD. A pilot study confirmed the reliability of the questionnaire (Cronbach’s alpha = 0.72). Results: The majority of participants (82.3%) had good overall knowledge of ADHD. While most correctly identified core ADHD symptoms and its chronic nature, misconceptions persisted regarding gender differences and the need for private educational support. Attitudes were generally positive, with 80.1% supporting a role for PHC physicians in ADHD management, although 58.0% believed it is not their job. Only 33.7% reported diagnosing ADHD cases in the past year, and of those, 90.2% referred patients to specialists. Age and gender were significantly associated with knowledge levels (p = 0.049 and p = 0.004, respectively), whereas other factors showed no significant association. Conclusion: PHC physicians in Tabuk show generally good knowledge and a positive attitude toward ADHD, yet gaps in practice and misconceptions remain. Strengthening ADHD-specific training and enhancing PHC involvement in early identification and management are recommended to improve care delivery for affected children and adolescents. Keywords: ADHD, primary healthcare, knowledge, attitude, physicians, Tabuk, Saudi Arabia