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Clinical Crossroads
September 23/30, 1998

A 55-Year-Old Man With Attention-Deficit/Hyperactivity Disorder

Author Affiliations

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.

JAMA. 1998;280(12):1086-1092. doi:10.1001/jama.280.12.1086

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.