Attention-Deficit/Hyperactivity Disorder in Child Psychiatry: Diagnostic Challenges, Comorbidities and Comprehensive Management in a Clinical Context in Senegal

Attention-Deficit/Hyperactivity Disorder (ADHD) is a persistent neurodevelopmental disorder characterized by impairing levels of inattention, disorganization, and/or hyperactivity-impulsivity. Worldwide prevalence is estimated at approximately 5% among school-aged children. In Senegal, child and adolescent psychiatry is an emerging specialty facing major structural and sociocultural challenges. Social perceptions of the “agitated” or “distracted” child frequently oscillate between ordinary behavioral turbulence and mystical or religious interpretations, often delaying access to specialized medical care. In addition, the scarcity of standardized diagnostic tools validated in African settings complicates the establishment of accurate epidemiological data. This article is a narrative review illustrated by two clinical cases and aims to explore the clinical reality of ADHD in Dakar, with particular emphasis on the complexity of psychiatric comorbidities and current therapeutic limitations. The study is based on a review of recent literature, an analysis of DSM-5 diagnostic criteria adapted to local clinical practice, and an in-depth examination of two children followed at a diagnostic and treatment center in Dakar between December 2024 and October 2025. The findings highlight frequent delays in diagnosis due to cultural interpretations of agitation and the masking effect of excessive early screen exposure. Management remains severely limited by the near-total unavailability of psychostimulants, particularly methylphenidate, on the national market. Consequently, non-pharmacological interventions—including psychoeducation, parent training, educational support, and cognitive remediation—play a central role despite remaining difficult to access. ADHD in Senegal requires an integrative and multidisciplinary approach. Strengthening early screening capacities and improving access to pharmacological and psychosocial interventions should be considered major public health priorities in order to reduce the academic, social, and emotional burden associated with this disorder.