title: Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder.
abstract: OBJECTIVE
  The authors sought to achieve an improved understanding of the diagnosis of oppositional defiant disorder independent of its association with conduct disorder.
  
  
  METHODS
  Family interactions, social functioning, and psychiatric comorbidity were compared in clinically referred male and female subjects with oppositional defiant disorder alone (N=643) or with comorbid conduct disorder (N=262) and a psychiatric comparison group with neither oppositional defiant disorder nor conduct disorder (N=695).
  
  
  RESULTS
  Oppositional defiant disorder youth with or without conduct disorder were found to have significantly higher rates of comorbid psychiatric disorders and significantly greater family and social dysfunction relative to psychiatric comparison subjects. Differences between subjects with oppositional defiant disorder alone and those with comorbid conduct disorder were seen primarily in rates of mood disorders and social impairment. Oppositional defiant disorder was a significant correlate of adverse family and social outcomes when comorbid disorders (including conduct disorder) were controlled.
  
  
  CONCLUSIONS
  These results support the validity of the oppositional defiant disorder diagnosis as a meaningful clinical entity independent of conduct disorder and highlight the extremely detrimental effects of oppositional defiant disorder on multiple domains of functioning in children and adolescents.
authors.affiliation: Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, ACC-725, Boston, MA 02114, USA. greene@helix.mgh.harvard.edu
authors.forename: Ross W
authors.initials: RW
authors.lastname: Greene
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Stephanie
authors.initials: S
authors.lastname: Zerwas
authors.forename: Michael C
authors.initials: MC
authors.lastname: Monuteaux
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Goring
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
mesh_terms: D000293:Adolescent; D000367:Age Factors; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002648:Child; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment