ADHD with comorbid oppositional defiant disorder or conduct disorder: discrete or nondistinct disruptive behavior disorders

UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Adolescent; Aggression; Anxiety Disorders; Attention Deficit Disorder with Hyperactivity; Attention Deficit and Disruptive Behavior Disorders; Bipolar Disorder; Child; Comorbidity; Conduct Disorder; Depressive Disorder; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Juvenile Delinquency; Male


Behavioral Disciplines and Activities | Mental and Social Health | Mental Disorders | Psychiatric and Mental Health | Psychiatry and Psychology


OBJECTIVE: In children with ADHD who have comorbid disruptive behavior diagnoses distinctions between oppositional defiant disorder (ODD) and conduct disorder (CD) remain unclear. The authors investigate differences between ODD and CD in a large clinical sample of children with ADHD.

METHOD: Consecutively referred and systematically assessed male children and adolescents with either ADHD (n = 65), ADHD with ODD (n = 85), or ADHD with CD (n = 50) were compared using structured diagnostic interviews and parent, teacher, and clinician rating scales.

RESULTS: In children with ADHD, significant differences emerged between ODD and CD in the domains of delinquency, overt aggression, and ADHD symptom severity; ADHD with CD was most severe, followed by ADHD with ODD, and ADHD had the least severe symptoms. Distinctions between ADHD with CD and the other two groups were found for parenting, treatment history, and school variables.

CONCLUSION: Within the limits of a cross-sectional methodology, results support clinically meaningful distinctions between ODD and CD in children with ADHD.

DOI of Published Version



J Atten Disord. 2008 Sep;12(2):126-34. Epub 2007 Oct 12. Link to article on publisher's site

Journal/Book/Conference Title

Journal of attention disorders

Related Resources

Link to Article in PubMed