title: Prevalence of oppositional defiant disorder in Spain.
abstract: BACKGROUND
  Oppositional defiant disorder (ODD) is characterized by a pattern of negative, defiant, disobedient and hostile behavior toward authority figures. ODD is one of the most frequent reasons for clinical consultation on mental health during childhood and adolescence. ODD has a high morbidity and dysfunction, and has important implications for the future if not treated early.
  
  
  OBJECTIVE
  To determine the prevalence of ODD in schoolchildren aged 6-16 years in Castile and Leon (Spain).
  
  
  METHODS
  Population study with a stratified multistage sample, and a proportional cluster design. Sample analyzed: 1,049. Cases were defined according to DSM-IV criteria.
  
  
  RESULTS
  An overall prevalence rate of 5.6% was found (95% CI: 4.2%-7%). Male gender prevalence=6.8%; female=4.3%. Prevalence in secondary education=6.2%; primary education=5.3%. No significant differences by gender, age, grade, type of school, or demographic area were found. ODD prevalence without considering functional impairment, such as is performed in some research, would increase the prevalence to 7.4%. ODD cases have significantly worse academic outcomes (overall academic performance, reading, maths and writing), and worse classroom behavior (relationship with peers, respect for rules, organizational skills, academic tasks, and disruption of the class).
  
  
  CONCLUSIONS
  Castile and Leon has a prevalence rate of ODD slightly higher to that observed in international publications. Depending on the distribution by age, morbidity and clinical dysfunctional impact, an early diagnosis and a preventive intervention are required for health planning.
authors.affiliation: Salud Mental Infanto Juvenil, Hospital San Telmo, Palencia, Sanidad de Castilla y León, España. Electronic address: villalobos@cop.es.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: López-Villalobos
authors.affiliation: Servicio de Pediatría, Hospital Río Carrión, Complejo Asistencial de Palencia, Sanidad de Castilla y León, España.
authors.forename: Jesús María
authors.initials: JM
authors.lastname: Andrés-De Llano
authors.affiliation: Atención Primaria, Valladolid, Sanidad de Castilla y León, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Rodríguez-Molinero
authors.affiliation: Atención Primaria, Valladolid, Sanidad de Castilla y León, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Garrido-Redondo
authors.affiliation: Atención Primaria, Palencia, Sanidad de Castilla y León, España.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Sacristán-Martín
authors.affiliation: Atención Primaria, Valladolid, Sanidad de Castilla y León, España.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Martínez-Rivera
authors.affiliation: Atención Primaria, Palencia, Sanidad de Castilla y León, España.
authors.forename: Susana
authors.initials: S
authors.lastname: Alberola-López
authors.affiliation: Diputación de Palencia, Servicio de Juventud, España.
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Sánchez-Azón
mesh_terms: D000293:Adolescent; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D013030:Spain / Q000453:epidemiology
keywords: Adolescent; Adolescente; Child; Disruptive behavior disorders; Niño; Oppositional defiant disorder; Prevalence; Prevalencia; Trastorno negativista desafiante; Trastornos del comportamiento perturbador