Dr Biederman is Professor of Psychiatry, Harvard Medical School, and Psychiatrist, Massachusetts General Hospital, Boston.
Clinical Crossroads section editor:
Margaret A. Winker, MD, Senior Editor, JAMA.
DR PARKER: Mr L is a 55-year-old father of
twin boys who was recently diagnosed as having attention-deficit/hyperactivity
disorder (ADHD). He is general manager for a biotechnology company, lives
in a suburb of Boston, Mass, and has commercial managed care insurance, which
he is concerned may not cover his recent psychological evaluation.
His first memory of difficulties dates to high school. He tended to
procrastinate, not allow enough time to do homework, and have difficulty with
basic scheduling. His grades were so poor that he initially did not get into
college. He eventually completed college and matriculated in a doctoral program
at a prestigious university, but he dropped out because of difficulties focusing
and managing his time. Mr L attempted to improve the problems through reading
self-help books, attending seminars on time management, and receiving counseling,
but none of these helped. He also was troubled by his inability to stay with
one job for more than 2 or 3 years.
Biederman J. A 55-Year-Old Man With Attention-Deficit/Hyperactivity Disorder. JAMA. 1998;280(12):1086-1092. doi:10.1001/jama.280.12.1086