Conclusions
To the best of our knowledge, this study is the first report to confirm
the possibility of JFK’s diagnosis of ADHD in line with valid diagnostic
criteria. However, ADHD did not prevent JFK from achieving success
because he was able to surround himself with competent, detail-oriented
people (principally, his brother, Robert, who had the exact opposite
personality to JFK), and he was willing to delegate to them both
responsibility and authority.10 Although the concept
of ADHD had not existed during his lifetime, JFK preferred the central
stimulant amphetamine for pain management,3 which,
unintentionally, may have served as self-medication for his ADHD
condition.
Pinals et al.2 discussed that the presentation of
pain, including LBP in JFK, was centralized and could be attributed to
CNS dysfunction. CNS dysfunctions that cause centralized pain are
assumed to be a common basis for disorders such as myofascial pain,
failed back syndrome, fibromyalgia, IBS, and chronic prostatitis, many
of which could be identified in Kennedy’s medical history. More
recently, ADHD has been suggested to be associated with CNS dysfunction
in chronic pain, and this pain can be improved by ADHD medication
(methylphenidate and/or atomoxetine).7 In addition to
pain disorders, conditions such as fibromyalgia, IBS, insomnia,
malabsorption, hypothyroidism, and allergies, which were present in JFK,
are all physical disorders associated with ADHD.20Given this information, ADHD appears to be a plausible cause of the
numerous illnesses that afflicted JFK.
Moreover, in a previous study,21 symptoms in patients
with chronic pain, including persistent chronic nonspecific LBP,
improved with ADHD medications; it was found that the pain and ADHD
symptoms of patients with chronic pain and comorbid ADHD tend to improve
with ADHD treatment. The results showed that 35 of 110 patients (31.8%)
with chronic pain at various sites, who were referred to a psychiatrist
at a pain clinic, were finally diagnosed with ADHD. Of these 35
patients, 21 received adjusted ADHD medications (methylphenidate and/or
atomoxetine). Twenty of the 21 medicated patients (95.5%) experienced
an improvement in their ADHD symptoms, and 14 of 21 patients (66.7%)
experienced a simultaneous improvement in their pain symptoms, as
evaluated using the numerical
rating scale (NRS). The NRS scores of the 14 patients decreased by 4.6 ±
2.6 points (64.7 ± 30.1%). Moreover, considering that there were only 7
patients with persistent chronic nonspecific LBP (among the 21 patients
with chronic pain at various sites) who received adjusted medication, 7
of 7 (100%) experienced reduction in pain symptoms, as measured using
the NRS (4.3 ± 2.6 points, 65.3 ± 28.2%).
Additionally, Kennedy’s son was diagnosed with
ADHD,5,6 and numerous tragedies have been attributed
to thrill-seeking behaviors in the Kennedy family, suggesting the
possibility of genetic ADHD.5 On the positive side,
such thrill-seeking behavior increases the likelihood of gaining
spectacular success, as demonstrated by the Kennedy family’s position in
politics.5
Furthermore, behind JFK’s success, his continued anxiety and fear of
rejection from his father, who forced him to become a politician like a
surrogate doll, was one of the main conflicts in JFK’s
life.3 As suggested by Lumley et al., JFK’s
centralized pain would have improved if he had been able to sufficiently
resolve conflicts by facilitating emotional processing, such as writing
“an unsent letter” to his father.1
The limitation of this study is that the ADHD diagnosis of JFK is a
hypothetical diagnosis based on the description in the published
literature, as the authors did not directly examine JFK.
The President’s Panel on Mental Retardation,22organized by Kennedy as one of his frontier policies, contributed to the
creation of the term “developmental disability,” which now includes
ADHD in the United States Public Law.23 After 60
years, the seeds of his ideals have budded and borne findings of a link
between ADHD and centralized pain, and is about to pave the way for the
treatment of centralized pain—a condition that he had suffered from
during his lifetime.