[Risk factors of attention deficit hyperactivity disorder comorbid with oppositional defiant disorder in children]

To explore risk factors of attention deficit hyperactivity disorder (ADHD) comorbid with oppositional defiant disorder (ODD) in children.

parents of 43 pure ADHD+ODD children, and 43 pure ADHD children (criteria of DSM-IV; group matched by sex, age and ADHD subtypes) were asked to complete a set of investigation questionnaires including child and family information; family history; pregnancy, delivery and infancy complications; physical development and temperament; and predisposing factors and parents' or teachers' responses toward children's misbehaviors.

probabilities of psychosis or schizophrenia of family members, long-term conflict between parents and parents' constant/stringent criticism to children in ADHD+ODD group were significantly higher than those in ADHD group (psychosis or schizophrenia of family members (16% vs 2%, P=0.058, OR=8.167); long-term conflict between parents (23% vs 7%, P=0.035, OR=4.040); parents' constant/stringent criticism to children (51% vs 28%, P=0.027, OR=2.706); probability of having anoxia at birth in ADHD group was significantly higher than that in ADHD+ODD group (12% vs 0, P=0.055, OR=0.469). Setting diagnosis of ADHD+ODD as dependent variable, and factors with significant difference between the two groups as independent variables, after 2 steps of regression analyses, one factor, i.e. parents' constant/stringent criticism to children was left in the model (P=0.054, OR=2.879). The regression formula had a sensitivity of 53.5%, a specificity of 83.7%, and total correction rate of 68.6%.

Inappropriate parenting is a risk factor of ADHD comorbid with ODD, and long-term conflict between parents and positive family history of psychoses might have influence on ADHD comorbid with ODD.