ODD, ADHD, versus ODD+ADHD in clinic and community adults

To seek evidence for the validity of oppositional defiant disorder (ODD) as a behavioral syndrome in adults.

Two samples of adults, mental health outpatient clinic referrals (N = 490) and community controls (N = 900), completed a Diagnostic and Statistic Manual of Mental Disorders-referenced rating scale and a brief questionnaire (social, educational, occupational, and treatment variables). Participants were separated into four groups: ODD-only, ADHD-only, ODD+ADHD, and NONE.

In general, the three symptom groups were more severe than the NONE group; the ODD+ADHD and NONE groups were the most and least severe, respectively; and there were clear differences between the ODD-only and ADHD-only groups. The pattern of group differences was generally similar in both samples.

Findings support the distinction between ADHD and ODD symptom presentations in adults, and the notion that the comorbid condition is a unique clinical entity, both of which are consistent with the child literature. Nevertheless, additional research with larger samples of patients will be necessary to establish ODD as a potential behavioral syndrome in adults.