ADHD in an underserved context: how Chinese social media users discuss recognition, care, and difficulty

Introduction: Attention-deficit/hyperactivity disorder (ADHD) remains under-recognized and underdiagnosed in China, particularly among adolescents and adults. As formal diagnosis and treatment remain difficult to access, ADHD has become increasingly visible on social media platforms such as RedNote, where users share experiences, compare symptoms, and seek information outside clinical settings. Understanding how ADHD is discussed in these spaces is important for mental health literacy, stigma reduction, and pathways to care. Materials and methods: Using a computational approach, we examined how ADHD is discussed on Chinese social media. We analyzed 47,612 valid user comments from the 50 most-commented posts that were obtained through searching the keyword “ADHD” on RedNote. We used Structural Topic Modeling (STM) to identify latent thematic clusters and Semantic Network Analysis (SNA) to examine how key terms co-occurred across the corpus. Results: Four themes were identified: school difficulties and family communication; managing attention and task completion; clinical diagnosis and treatment; and academic performance and evaluation concerns. Clinical diagnosis and treatment was the most prevalent theme. The semantic network showed that “oneself” and “ADHD” were the most highly connected terms, and that diagnostic vocabulary co-occurred with everyday language about schooling, self-management, and family life. Conclusions: On RedNote, ADHD is discussed largely through the language of schooling, academic performance, and family life rather than in strictly clinical terms, with diagnostic language interwoven with first-person accounts of everyday difficulty. These patterns describe how ADHD is collectively discussed and can inform culturally grounded mental health communication and screening for digitally engaged populations. Future interview-based, longitudinal, and cross-platform research could test whether these patterns hold more broadly.