Is Oppositional Defiant Disorder a Meaningful Diagnosis in Adults?

Harpold, Theresa; Biederman, Joseph; Gignac, Martin; Hammerness, Paul; Surman, Craig; Potter, Anya; Mick, Eric

doi:10.1097/nmd.0b013e318093f448

Cited by 52 publications

(27 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a study examining the rates and clinical correlates of ODD in psychiatrically referred adults (n = 219), nearly one-half of the sample had a history of ODD and more than one-half had ODD without CD. 11 Adults with a lifetime history of ODD also had high rates of comorbid BD, anxiety, and SUDs. These findings are consistent with other studies describing comorbidity in children with ADHD and ODD (for example, Biederman,et al 12 ).…”

Section: Axis I Disorders and Adhdmentioning

confidence: 99%

Comorbidity in Adults with Attention-Deficit Hyperactivity Disorder

2009

View full text Add to dashboard Cite

Objective: To examine the prevalence of comorbid Axis I (current and lifetime) and II disorders in adult men and women with attention-deficit hyperactivity disorder (ADHD). Method:Adult patients (n = 447; 266 men, 181 women) received comprehensive assessments for ADHD and Axis I and II disorders. Adults were aged between 17 and 74 years. Among the patients diagnosed with ADHD (n = 335), there were those with ADHD inattentive subtype (ADHD-I) (n = 199), hyperactive-impulsive subtype (ADHD-H) (n = 24), or combined ADHD subtype (ADHD-C) (n = 112). Chi-square and logistic regression analyses were performed to examine associations between adults with and without ADHD on Axis I and II disorders.Results: Adults with ADHD, compared with those without ADHD, had higher rates of Axis I (46.9% and 27.31%) and Axis II (50.7% and 38.2%) disorders. Adults with ADHD-C were more likely to have mood disorder, anxiety, conduct disorder, and substance use disorder as well as obsessive-compulsive personality disorder, passive-aggressive personality disorder, depressive personality disorder, narcissistic personality disorder, and borderline personality disorder (BPD).Men with ADHD were more likely to have antisocial personality disorder and had higher rates of current drug abuse than women with ADHD. Women with ADHD had higher rates of past and current panic disorder, and past anorexia and bulimia. Women with ADHD were more likely to have BPD than men with ADHD. Conclusions:Adults with ADHD have very high rates of comorbid Axis I and II disorders, with differences found between men and women on certain comorbid disorders.Can J Psychiatry. 2009;54(10):673-683. Clinical Implications· In diagnosing and treating adults with ADHD, the assessment and treatment of other conditions that may be comorbid with ADHD is crucial to adequately treat patients and promote optimal outcome. · One-third of patients referred for ADHD diagnosis do not have ADHD but may have other conditions. · Comprehensive, systematic evaluations are crucial for accurate diagnosis and comprehensive treatment. Limitations· Exclusion criteria, which included current substance abuse and psychiatric conditions, and which required urgent treatment, might have resulted in a decrease in the level of comorbidity found. · Sources of referral (for example, self-and physician-referral) might also have selected for a less comorbid patient population.

show abstract

Section: Axis I Disorders and Adhdmentioning

confidence: 99%

Comorbidity in Adults with Attention-Deficit Hyperactivity Disorder

2009

View full text Add to dashboard Cite

show abstract

“…From 45% to 84% of youngsters with ADHD will meet full diagnostic criteria for ODD with or without CD [3,9]. In studies of clinically referred adults with ADHD, 43% had a lifetime history of ODD [10]. These data confi rm that ODD is one of the most common comorbid disorders in clinically referred ADHD samples across the life span.…”

Section: Prevalence With and Without Adhdmentioning

confidence: 76%

Attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder or conduct disorder

Connor

Doerfler²

2009

Curr Atten Disord Rep

View full text Add to dashboard Cite

Comorbid oppositional defiant disorder (ODD) and conduct disorder (CD) are common in clinically referred children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Early recognition and treatment of co-occurring ADHD and ODD and/or CD is important because comorbidity influences symptom severity, prognosis, and treatment. Research on treatment supports the importance of behavior therapies for ODD and multimodal psychosocial interventions delivered simultaneously and intensively for CD with adjunctive medication for ADHD symptoms. Clinical trials are beginning to show that stimulants and atomoxetine are effective for ADHD and ODD symptoms when the disorders occur together. It is presently unclear if ODD in the absence of ADHD responds to pharmacotherapy. More research is needed examining the effects of commonly prescribed ADHD medications on CD symptoms. Research suggests a high prevalence of lifetime comorbidity with ODD in clinically referred patients with ADHD

show abstract

“…ODD or CD comorbid with ADHD have been reported to be associated with some features of ADHD (i.e., increased impulsivity and reduced inattention), when compared with children with ADHD and anxiety disorders [48], while comorbid ODD has been associated with the severity of ADHD [27,36,49], social withdrawal [49], depression, anxiety, school refusal [50], substance use disorders [17], personality disorder features [51], decreased psychosocial functioning [17,49], neuropsychological performance [52] (e.g., impaired impulse control) and reduced response to medication [24]. The present results, while consistent with these findings, indicate that an ADHD subtype based on ODD comorbidity may have greater validity in relation to features of ADHD and severity, when compared with CD comorbidity.…”

Section: Main Findingsmentioning

confidence: 99%

“…Also, in two studies in adults with ADHD [17,28], 43% and 46.3% respectively had a history of ODD. In the latter study, past ODD was not considered to be excluded by comorbid CD and the mean number of endorsed ODD criteria for all subjects was 3.59; the most frequently endorsed features were: 'defying', 'touchy or easily annoyed', 'arguing', 'losing temper' and being 'angry and resentful'.…”

Section: Prevalence and Associations Of Odd And CD When Comorbid Witmentioning

confidence: 99%

See 1 more Smart Citation

Associations of Past Oppositional Defiant Disorder in Adults with Attention-Deficit/Hyperactivity Disorder~!2008-09-19~!2008-10-22~!2008-11-28~!

Dowson¹

2008

TOPJ

View full text Add to dashboard Cite

Abstract:Objective: While DSM-IV Attention-deficit/hyperactivity disorder (ADHD) comorbid with antisocial behaviours identified by DSM-IV conduct disorder (CD) has been claimed as a 'distinct subtype', there is less information about the validity of a subtype based on the more prevalent comorbidity of oppositional defiant disorder (ODD). The present study investigated the associations of past ODD with past and recent psychopathology in adults with ADHD.Methods: 94 clinic-referred adults (73 male; 21 female) with DSM-IV ADHD, and their informants, completed questionnaires.Results: 59% of males had past ODD (with or without past CD), 42% had past CD (with or without past ODD) and 36% had past ODD and past CD; for females, 57%, 33% and 29% respectively. In males with the DSM-IV ADHD 'combined' type (i.e. the most common presentation of ADHD), ratings of past ODD, when compared with those of past CD, were more strongly correlated with past and recent ADHD-related hyperactivity/impulsivity and with past and recent functional impairment. In females, ratings of past ODD, compared with those of past CD, also yielded stronger correlations with features of ADHD. In males and females, ratings of past CD (but not of ODD) were correlated with features of personality disorders. Conclusions:The results indicated that ODD ( and a history of ODD) is relevant in studies of the validity of ADHD subtypes based on comorbid antisocial behaviour. Identification of valid subtypes is important for studies of clinical course and response to treatment.

show abstract

Is Oppositional Defiant Disorder a Meaningful Diagnosis in Adults?

Cited by 52 publications

References 10 publications

Comorbidity in Adults with Attention-Deficit Hyperactivity Disorder

Comorbidity in Adults with Attention-Deficit Hyperactivity Disorder

Attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder or conduct disorder

Associations of Past Oppositional Defiant Disorder in Adults with Attention-Deficit/Hyperactivity Disorder~!2008-09-19~!2008-10-22~!2008-11-28~!

Contact Info

Product

Resources

About