Attention-Deficit Disorder

Abstract

SELECTED CASES Patient 1 An 8-year-old boy was evaluated in the National Institutes of Health outpatient clinic in Bethesda, Md, for participation in research. The patient history was positive for 12 of the 14 criteria of attention-deficit hyperactivity disorder (ADHD) listed in the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R ) 1 (Table 1). Symptoms displayed by this patient included major disability due to poor attention span, impulsivity, distractibility, increased motor activity, and poor social skills. A structured psychiatric interview with his parents revealed no other causes of these symptoms by excluding the possibility of anxiety disorder or mood disorder, among others. (See Table 2 for differential diagnosis.) The physical examination yielded normal findings, and an evaluation of mental status revealed restlessness and poor impulse control characterized by the patient's repeated interruptions of the interviewer. A laboratory examination and psychometric testing indicated no learning disability but revealed