Managing attention deficit hyperactivity disorder in the emergency department.

ADHD, often misdiagnosed or unrecognized, can lead to serious personal and family disruption. Younger patients with ADHD frequently present to hospital emergency departments with crises involving behavioral dyscontrol, legal, school or family conflict, and substance abuse. An emergency room visit provides an excellent opportunity to use such crises as catalysts to effect lasting change in these patients and their families. The efficacy of a biopsychosocial model is demonstrated in a case involving a 15-year-old boy presenting to the emergency department with legal, psychological, educational, and family problems. Multiple teaching points are highlighted throughout the case.