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      Comorbid Psychiatric Symptom Associated With Oppositional Defiant Symptom in Community School-Age Children

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          Abstract

          Objectives

          Oppositional defiant disorder (ODD) is often comorbid with other psychiatric disorders in childhood. This study aimed to investigate comorbid psychiatric symptoms and associated factors in elementary school children with symptoms of ODD.

          Methods

          The participants consisted of 205 mother-offspring pairs. Psychiatric symptoms were measured using the Diagnostic Predictive Scales and Korean Child Behavior Checklist. Psychiatric comorbid symptoms were compared between children with ODD symptom and those without ODD symptom. Multivariate logistic regression analysis was used to estimate the odds ratio of psychiatric symptom on ODD.

          Results

          ODD group had a significant association with internalizing and externalizing problem (p=0.001, p<0.001, respectively). ODD group were more comorbid with anxiety disorder, depressive disorder, attention-deficit/hyperactivity disorder, and conduct disorder. Among psychiatric disorder, generalized anxiety disorder (GAD) (adjusted odds ratio [AOR]=18.620, p<0.001) and conduct disorder (AOR=9.529, p=0.014) were associated with ODD symptom.

          Conclusion

          These findings suggest that children with ODD symptom had significantly higher rates of comorbid psychiatric symptoms. And GAD and conduct disorder are related to ODD symptom.

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          Most cited references28

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          Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study.

          B Birmaher, D A Brent, L Chiappetta … (1999)
          To replicate and extend work on the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED), a child and parent self-report instrument used to screen for children with anxiety disorders. The 41-item version of the SCARED was administered to a new sample of 190 outpatient children and adolescents and 166 parents. The internal consistency, discriminant, and convergent validity were assessed. In addition, using discriminant function analysis, a briefer version of the SCARED was developed. Using item analyses and factor analyses on the 41-item version, 5 factors were obtained: panic/somatic, generalized anxiety, separation anxiety, social phobia, and school phobia. In general, the total score and each of the 5 factors for both the child and parent SCARED demonstrated good internal consistency and discriminant validity (both between anxiety and depressive and disruptive disorders and within anxiety disorders). A reduced version of the SCARED yielded 5 items and showed similar psychometrics to the full SCARED. In a new sample, the authors replicated their initial psychometric findings that the SCARED is a reliable and valid instrument to screen for childhood anxiety disorders in clinical settings. Furthermore, pending future research, the 5-item SCARED appears to be a promising brief screening inventory for anxiety disorders in epidemiological studies.
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            The DISC Predictive Scales (DPS): efficiently screening for diagnoses.

            C P Lucas, H Zhang, P W Fisher … (2001)
            To derive and test a series of brief diagnosis-specific scales to identify subjects who are at high probability of meeting diagnostic criteria and those who may safely be spared more extensive diagnostic inquiry. Secondary data analysis of a large epidemiological data set (n = 1,286) produced a series of gate and contingent items for each diagnosis. Findings were replicated in a second retrospective analysis from a residential care sample (n = 884). The DISC Predictive Scales (DPS) were then used prospectively as a self-report questionnaire in two studies, in which parents (n = 128) and/or adolescents (n = 208) had subsequent diagnostic interviewing with the Diagnostic Interview Schedule for Children or the Schedule for Affective Disorders and Schizophrenia for School-Age Children. All analyses showed that gate item selection was valid and that any missed cases were due solely to inconsistent reports on the same questions. Screening performance of the full scales was shown to be good, and substantial reductions in scale length were not associated with significant changes in discriminatory power. The DPS can accurately determine subjects who can safely be spared further diagnostic inquiry in any diagnostic area. This has the potential to speed up structured diagnostic interviewing considerably. The full DPS can be used to screen accurately for cases of specific DSM-III-R disorders.
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              Developmental transitions among affective and behavioral disorders in adolescent boys.

              Paul Rathouz, Benjamin B. Lahey, Rolf Loeber … (2005)
              This paper expands upon recent efforts to advance beyond the examination of concurrent comorbidity between affective and behavioral disorders by testing developmental sequences among disorders. Doing so allows for improved tests of theories, such as Capaldi and Patterson's failure model of Conduct Disorder (CD) and depression. Furthermore, Oppositional Defiant Disorder (ODD) is rarely considered distinctly from CD, minimizing the ability to identify distinct effects among behavioral disorders. This paper used data from the Developmental Trends Study, a clinic-referred cohort of 177 boys, along with their parents, who were assessed regularly using a structured clinical interview and a comprehensive set of other measures. Boys were recruited when they were between the ages of 7 and 12, and were reassessed annually until age 18. Predictive regression models tested the continuities among disorders, with depression, overanxious disorder, Attention Deficit Hyperactivity Disorder (ADHD), ODD and CD examined separately as outcomes. Each disorder showed homotypic continuity, but a clear developmental sequence of heterotypic continuity also emerged. ADHD was predicted by no other disorders, and exclusively predicted ODD. CD was predicted only by ODD. However, ODD was also directly predictive of future anxiety and depression, and anxiety predicted future depression as well. A specific test of the failure model of CD and depression supported that model. ODD appears as a pivotal developmental disorder in young males, in that ODD is notably influential in both subsequent behavioral and affective disorders. CD influences later depression only indirectly, through psychosocial impairment. Anxiety precedes depression, and ADHD is not predicted by other disorders.
              Article 0 comments Cited 60 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Soa Chongsonyon Chongsin Uihak
                Journal ID (iso-abbrev): Soa Chongsonyon Chongsin Uihak
                Journal ID (publisher-id): J Korean Acad Child Adolesc Psychiatry
                Title: Journal of the Korean Academy of Child and Adolescent Psychiatry
                Publisher: Korean Academy of Child and Adolescent Psychiatry
                ISSN (Print): 1225-729X
                ISSN (Electronic): 2233-9183
                Publication date (Print): 1 July 2023
                Publication date (Electronic): 1 July 2023
                Publication date PMC-release: 1 July 2023
                Volume: 34
                Issue: 3
                Pages: 169-174
                Affiliations
                [1 ]Jeju National University School of Medicine, Jeju, Korea
                [2 ]Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
                Author notes
                Address for correspondence: Na Ri Kang, Department of Psychiatry, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju 63241, Korea Tel: +82-64-717-1850, Fax: +82-64-717-1849, E-mail: ilnaree@ 123456hanmail.net
                Author information
                https://orcid.org/0009-0003-1533-3270
                https://orcid.org/0000-0001-7878-3410
                https://orcid.org/0000-0002-2086-0927
                Article
                Publisher ID: jkacap-34-3-169
                DOI: 10.5765/jkacap.230026
                PMC ID: 10326355
                PubMed ID: 37426832
                SO-VID: 21a9071f-292e-41a6-9b77-93736c49f715
                Copyright © Copyright © 2023 Korean Academy of Child and Adolescent Psychiatry
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 18 April 2023
                Date revision received : 16 May 2023
                Date accepted : 16 May 2023
                Categories
                Subject: Original Article

                Keywords: oppositional defiant disorder,children,comorbidity
                Data availability:
                Keywords: oppositional defiant disorder, children, comorbidity

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