Ml. Speltz et al., Preschool boys with oppositional defiant disorder: Clinical presentation and diagnostic change, J AM A CHIL, 38(7), 1999, pp. 838-845
Citations number
25
Categorie Soggetti
Psychiatry
Journal title
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
Objective: Little is known about the clinical presentation and course of op
positional defiant disorder (ODD) when first diagnosed in the preschool yea
rs. Patterns of ODD symptomatology, comorbidity, persistence of disorder, a
nd predictors of diagnostic outcome were examined in clinic-referred presch
ool boys. Method: Boys (aged 4-5.5 years) with a DSM-III-R diagnosis of ODD
were prospectively followed over a 2-year period. Multiple assessment proc
edures were used, including a modified version of the Diagnostic Interview
Schedule for Children and parent and teacher ratings. Results: Ninety-two b
oys (mean age 56.9 months) with ODD were followed; 42 had comorbid attentio
n-deficit hyperactivity disorder (ADHD). Among 79 boys assessed 2 years lat
er, 76% had ODD, ADHD, or both. Of those, 25% had other diagnoses as well,
primarily anxiety and/or mood disorders. Conduct disorder was rare. Subject
s with comorbid ODD/ADHD at intake were significantly more likely to have a
psychiatric disorder at follow-up, especially ADHD alone. Conclusions: The
findings suggest that ODD in the preschool period is a clear indicator of
high risk, especially when co-occurring with ADHD. Further investigation of
individual patterns of ODD symptom expression is recommended.