Results from this large-scale study confirm and extend previous findings in the epidemiology of the disruptive behaviour disorders.

In a systematic review of cohort studies of adolescent drinking and later outcomes, Jim McCambridge and colleagues show that although studies suggest links to worse adult physical and mental health and social consequences, existing evidence is of poor quality.

DSM-IV specifies a developmental relationship between Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD). Evidence for this link is mixed, however, and recent studies suggest that different symptom dimensions in ODD may have different outcomes. We examined links between ODD, CD and their young adult outcomes in the Great Smoky Mountains Study; a longitudinal dataset with over 8000 observations of 1420 individuals (56% male) covering ages 9 to 21 years. ODD was a significant predictor of later CD in boys but not in girls after control for comorbid CD and sub-threshold CD symptomatology. Transitions between ODD and CD were less common than anticipated, however, particularly during adolescence. We examined characteristics and outcomes of children with pure ODD, pure CD and combined CD/ODD. Alongside many similarities in childhood and adolescent correlates, key differences were also identified: CD largely predicted behavioral outcomes, whereas ODD showed stronger prediction to emotional disorders in early adult life. Factor analysis identified irritable and headstrong dimensions in ODD symptoms that showed differential prediction to later behavioral and emotional disorders. Overall, the results underscore the utility of retaining separate ODD and CD diagnoses in DSM-V.

Subtyping CD using CU traits identifies children with more severe and persistent psychopathology. Children with high CU traits but no CD diagnosis require further investigation.

ODD and ADHD, rather than conduct disorder, appear to be the externalizing disorders associated with unintentional injury. We discuss possible models of the relationships between internalizing disorders and unintentional injury.