ADHD with comorbid oppositional defiant disorder or conduct disorder: discrete or nondistinct disruptive behavior disorders?
OBJECTIVE
In children with ADHD who have comorbid disruptive behavior diagnoses distinctions between oppositional defiant disorder (ODD) and conduct disorder (CD) remain unclear. The authors investigate differences between ODD and CD in a large clinical sample of children with ADHD.


METHODS
Consecutively referred and systematically assessed male children and adolescents with either ADHD (n = 65), ADHD with ODD (n = 85), or ADHD with CD (n = 50) were compared using structured diagnostic interviews and parent, teacher, and clinician rating scales.


RESULTS
In children with ADHD, significant differences emerged between ODD and CD in the domains of delinquency, overt aggression, and ADHD symptom severity; ADHD with CD was most severe, followed by ADHD with ODD, and ADHD had the least severe symptoms. Distinctions between ADHD with CD and the other two groups were found for parenting, treatment history, and school variables.


CONCLUSIONS
Within the limits of a cross-sectional methodology, results support clinically meaningful distinctions between ODD and CD in children with ADHD.
Connor
Daniel F
DF
University of Connecticut Medical School, Farmington, CT 06030-1410, USA. connor@psychiatry.uchc.edu
Doerfler
Leonard A
LA
D000293:Adolescent; D000374:Aggression / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis / Q000453:epidemiology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency / Q000706:statistics & numerical data; D008297:Male