Oppositional defiant disorder and the explanation of the comorbidity between behavioral disorders and depression.

Abstract

[Clin Psychol Sci Prac 17: 319–326, 2010] Many studies have shown that conduct disorder (CD) and depression often co-occur in late childhood and adolescence and have historically been regarded as the primary point of comorbidity between internalizing and behavioral disorders. On the other hand, recent evidence suggests that oppositional defiant disorder (ODD), and not CD, may best explain the comorbidity between disruptive behavior disorders and depression. ODD typically onsets before CD and depression, changes in ODD symptoms predict changes in symptoms of CD and depression from one year to the next, and ODD in childhood and adolescence predicts depression in adulthood. Emerging evidence suggests that there are affective and behavioral dimensions of ODD symptoms, and those affective ODD symptoms (and not the behavioral symptoms) best predict later depression. These results are highly relevant not only for our understanding of the etiology of the disorders, but also for optimizing early interventions aimed at reducing irritability in some ODD children. The new findings also stimulate new questions to be addressed with future research.