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Oppositional defiant disorder

J M Rey1

  • 1Rivendell Child Adolescent and Family Psychiatric Services, Royal Prince Alfred Hospital, Sydney, Australia.

The American Journal of Psychiatry
|December 1, 1993
PubMed
Summary
This summary is machine-generated.

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Oppositional defiant disorder (ODD) shows distinct features from conduct disorder, though diagnostic reliability needs improvement. Further research is needed to clarify its place in psychiatric nosology.

Area of Science:

  • Child and Adolescent Psychiatry
  • Behavioral Psychology
  • Psychiatric Nosology

Background:

  • Oppositional defiant disorder (ODD) is a common diagnosis with ongoing debate regarding its distinctness.
  • Previous diagnostic manuals (DSM-III to DSM-IV) have seen significant revisions to ODD criteria.
  • Limited research has focused on ODD, prompting a review of its nosological standing.

Purpose of the Study:

  • To review existing literature on oppositional defiant disorder.
  • To establish the validity and place of ODD within psychiatric classification systems.
  • To analyze the relationship between ODD and conduct disorder.

Main Methods:

  • Comprehensive literature search using terms like "oppositional disorder" and "oppositional defiant disorder."

Related Experiment Videos

  • Supplementation of computerized searches with reference tracking and epidemiological data.
  • Inclusion of non-computerized literature searches to ensure broad coverage.

    • Main Results:

    • Multivariate analyses suggest ODD is distinct from conduct disorder.
    • ODD affects one-third of psychiatrically diagnosed children in the community and is associated with frequent mental health service use.
    • ODD symptoms demonstrate temporal stability and differ in developmental profile and sex distribution compared to conduct disorder, despite low diagnostic reliability.

    Conclusions:

    • Evidence supports ODD representing an oppositional-aggressive dimension separate from delinquency.
    • Limited support exists for integrating ODD into conduct disorder or including "lying" as a diagnostic criterion.
    • Recommendations include requiring considerable impairment for diagnosis and refining symptom descriptions to enhance reliability.