Attitudes and opinions of healthcare professionals working in family health centers in Erzincan regarding attention deficit and hyperactivity disorder

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity, manifesting across childhood, adolescence, and adulthood. Symptomatology varies by age; while hyperactivity is more prominent in childhood, difficulties in attention and executive functioning become more apparent in adulthood. ADHD negatively affects academic, occupational, and social functioning, leading to reduced employment, increased risky behaviors, and interpersonal difficulties. Primary care health professionals play a critical role in early detection, appropriate referral, and family counseling, as they constitute the first point of contact for individuals with ADHD. Accordingly, the aim of this study was to assess the knowledge and awareness levels of family physicians and allied health personnel regarding ADHD, and to contribute to the development of future screening and follow-up protocols based on the findings. Methods: This study was conducted with health professionals working in 32 Family Health Centers in Erzincan, Turkey. A total of 85 family physicians and 65 allied health personnel were recruited. After excluding four incomplete questionnaires, data from 144 participants were analyzed. Data collection was performed using a 37-item questionnaire prepared by an academic committee and validated for scientific reliability. The questionnaire consisted of 14 items on sociodemographic characteristics and 23 items assessing knowledge, attitudes, and awareness of ADHD. It included six open-ended, eleven multiple-choice, and nineteen closed-ended questions, structured on three- and five-point Likert scales. Knowledge assessment covered ADHD etiology, core symptoms, diagnosis, clinical course, and treatment, while referral accuracy and attitudes were also evaluated. Results: Of the 144 participants, 63.2% were female, with a mean age of 36.8±8.1 years, mean professional experience of 12.6±7.8 years, and mean duration of family medicine practice of 7.2±5.1 years. Participants reported seeing an average of 57 patients per day, of which 4 approximately 13 were children. Physicians constituted 54.2% of the sample, while allied health personnel accounted for 45.8%. A total of 40.9% reported prior training on ADHD, and 27.1% indicated having a relative diagnosed with ADHD. In suspected ADHD cases, 86.1% stated they would refer the child to a child and adolescent psychiatrist. Regarding treatment approaches, 47.9% considered cognitive-behavioral therapy the most effective, followed by family education (22.9%) and pharmacological treatment (18.8%). Furthermore, 84% emphasized adherence to child psychiatry specialists' recommendations for medication use. The mean knowledge score was 9.27±4.16, with physicians scoring significantly higher than allied health personnel (p<0.001). Participants with prior ADHD training or with a relative diagnosed with ADHD obtained significantly higher scores (p<0.001). No significant differences were observed in knowledge scores across physician titles. Conclusion: This study demonstrated that the overall knowledge level of primary care health professionals regarding ADHD was moderate, with marked deficiencies particularly in diagnosis, clinical course, and treatment. Although awareness of core symptoms was relatively high, this did not adequately translate into diagnostic and management processes. The higher scores among participants with prior training highlight the effectiveness of targeted education, yet the finding that only 40% had received such training suggests inadequacies in both undergraduate and postgraduate curricula. The absence of significant differences across physician titles indicates that individual interest and continuing education are more critical determinants of knowledge level. Moreover, the higher scores among those with a relative diagnosed with ADHD underscore the contribution of personal experience. In conclusion, for primary care health professionals to play a more effective role in the diagnosis, treatment, and long-term management of ADHD, regular case-based training programs, along with the development of national guidelines and screening initiatives, are strongly recommended.