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Is Oppositional Defiant Disorder a Meaningful Diagnosis in Adults?: Results From a Large Sample of Adults With ADHD

Harpold, Theresa MD*; Biederman, Joseph MD*; Gignac, Martin MD; Hammerness, Paul MD*; Surman, Craig MD*; Potter, Anya BS*; Mick, Eric ScD*

The Journal of Nervous and Mental Disease: July 2007 - Volume 195 - Issue 7 - p 601-605
doi: 10.1097/NMD.0b013e318093f448
Original Article

We examined the prevalence and clinical characteristics of oppositional defiant disorder (ODD) in a sample of clinically referred adults with attention deficit hyperactivity disorder (ADHD). Subjects were consecutively referred adults with a DSM-III R/IV diagnosis of ADHD with or without ODD. Nearly half of subjects (43%) had a history of ODD. Subjects with a childhood history of ODD had increased risk for bipolar disorder, multiple anxiety disorders, and substance use disorders relative to the ADHD subjects without ODD. We concluded, as in children with ODD, adults with a childhood history of ODD have high rates of psychiatric comorbidity and more impaired psychosocial functioning than those without this condition. A better understanding of the course, phenomenology, and clinical significance of ODD in adults is needed to better understand therapeutic approaches for this disorder.

*Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston, Massachusetts; and †Institute Philippe Pinel, Université de Montréal, Montréal, Quebec.

This work was supported by National Institutes of Health grant KO1 MH065523 (EM) and by an unrestricted research grant from Shire, PLC.

Send reprint requests to Eric Mick, ScD, Pediatric Psychopharmacology Research Unit, Massachusetts General Hospital, 55 Fruit Street, Warren 705, Boston, MA 02114. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.