Prim Care Companion J Clin Psychiatry 2007;9(4):321-324
© Copyright 2014 Physicians Postgraduate Press, Inc.
Objective: To examine precursors of adolescent conduct disorder (CD) in
children with attention-deficit/hyperactivity disorder (ADHD), examining the
role of childhood oppositional defiant disorder (ODD) and ADHD.
Method: The investigators evaluated 151 children with ADHD using standard
diagnostic interviews at ages 6 to 13 years and 5 years later in adolescence.
The subjects were recruited from child psychiatric and pediatric clinics. Multiple
regression analysis was used to evaluate baseline ODD diagnosis and ODD, CD,
and ADHD symptom scores as clinical predictors of adolescent CD diagnosis
and symptom scores.
Results: There was a significant association between childhood ODD (diagnosis
and severity) and adolescent CD (diagnosis and severity). The association
was independent of childhood ADHD severity and childhood CD. Children with
a diagnosis of ODD were almost 3 times more likely to develop CD in adolescence
(odds ratio = 2.79, 95% CI = 1.16 to 6.70, p = .02). Although there was a
trend toward association, adolescent CD scores, but not diagnosis of CD, were
predicted by the severity of childhood ADHD. Adolescent CD severity was predicted
by the presence of at least 1 CD symptom in childhood.
Conclusions: Regardless of ADHD severity, ODD is a significant precursor
of adolescent CD in children with ADHD. Given that ADHD with comorbid CD
has a poor prognosis, it is critical that clinicians be especially vigilant for childhood