Helping Clinicians to Detect ODD in Children with ADHD in Clinical Settings
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Helping Clinicians to Detect ODD in Children with ADHD in Clinical Settings Akın Tahillioğlu 1 & Nurhak Dogan 1
1
& Eyüp Sabri Ercan & Luis Augusto Rohde
2,3
Accepted: 18 October 2020/ # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
The objectives of this study were to provide a basic tool for pediatricians or other physicians to suspect and detect ODD in children with ADHD and to distinguish the symptomatic profile of ODD from ADHD. 101 subjects with ADHD, 83 with both ADHD and ODD and 342 controls aged 8 to 15 years were included in the study. A semistructured interview was performed for evaluation of psychiatric diagnoses. Both parents and teachers completed DSM-IV Disruptive Behavior Disorders Rating Scale. We found differences among all three diagnostic subsamples in two-by-two analyses for all dimensions (Inattention, Hyperactivity/Impulsivity and ODD) both according to parent and teacher reports (p < 0.03 for all analyses). Based on parental ODD scores, ROC Curve analyses between ‘only ADHD’ and ‘ADHD+ODD’ groups showed that AUC was equal 0.80 (95%CI = 0.73–0.86) and the best cutoff point for ODD diagnosis in the ADHD subjects was 0.68. This study demonstrates the presence of a basic tool for detection and suspicion of ODD in children with ADHD for primary care clinicians or pediatricians in clinical settings. Findings also indicate that patients with ODD and ADHD have more severe inattention, hyperactivity/impulsivity and oppositional symptoms than those with only ADHD have. Keywords ODD . Oppositional defiant disorder . Clinician assessment . Diagnosis . ADHD
* Nurhak Dogan [email protected] Akın Tahillioğlu [email protected] Eyüp Sabri Ercan [email protected] Luis Augusto Rohde [email protected] Extended author information available on the last page of the article
Psychiatric Quarterly
Introduction A t t e n ti o n - D e f i c i t / H y p er a c t i v i t y D i s o r d e r ( A D H D ) i s a c h i l d h o o d - o ns e t neurodevelopmental disorder characterized by developmentally inappropriate inattention, motor hyperactivity, and impulsivity, with negative outcomes persisting into adulthood [1]. Two meta-analyses documented the pooled worldwide estimated prevalence of ADHD in children and adolescents indicating rates between 5.3% (95% CI: 5.01–5.56) [2] and 7.2% (95% CI: 5.01–5.56) [3]. The disorder has severe consequences for individuals and society, such as an increased risk for substance abuse, car accidents, and criminality. The disorder is also associated with significant impairments in familial, social, financial/economic, and educational functioning [4]. Frequently, a wide variety of concurrent psychiatric disorders contribute to the psychopathological status of children and adolescents with ADHD. The overall prevalence of psychiatric disorders accompanying ADHD in children and adolescents ranges from about 40 to 80% depending on the sample [5, 6]. Thus, in addition to an ADHD diagnosis, clinicians assessing children and adolescents affected by
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