Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder
Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder
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DOI：
10.1176/appi.ajp.159.7.1214
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发表时间：
2002-07-01
影响因子：
17.7
通讯作者：
Faraone, SV
中科院分区：
文献类型：
--
作者：
Greene, RW;Biederman, J;Faraone, SV
目的：作者试图更好地理解对立违抗性障碍的诊断，而不管其与品行障碍的关系如何。方法：对临床转诊的仅患有对立违抗性障碍（N = 643）或共病品行障碍（N = 262）的男性和女性受试者以及既没有对立违抗性障碍也没有品行障碍的精神病学对照组的家庭互动、社会功能和精神合并症进行比较(N=695)。结果：与精神科对照对象相比，患有或不患有品行障碍的对立违抗性障碍青少年的共病精神障碍发生率显着更高，家庭和社会功能障碍也明显更高。单独患有对立违抗障碍的受试者与患有共存品行障碍的受试者之间的差异主要体现在情绪障碍和社交障碍的发生率上。当共病障碍（包括品行障碍）得到控制时，对立违抗性障碍与不良家庭和社会结果显着相关。结论：这些结果支持对立违抗性障碍诊断作为独立于品行障碍的有意义的临床实体的有效性，并强调对立违抗性障碍对儿童和青少年多个功能领域的极其有害的影响。
Objective: The authors sought to achieve an improved understanding of the diagnosis of oppositional defiant disorder independent of its association with conduct disorder.Method: Family interactions, social functioning, and psychiatric comorbidity were compared in clinically referred male and female subjects with oppositional defiant disorder alone (N=643) or with comorbid conduct disorder (N=262) and a psychiatric comparison group with neither oppositional defiant disorder nor conduct disorder (N=695).Results: Oppositional defiant disorder youth with or without conduct disorder were found to have significantly higher rates of comorbid psychiatric disorders and significantly greater family and social dysfunction relative to psychiatric comparison subjects. Differences between subjects with oppositional defiant disorder alone and those with comorbid conduct disorder were seen primarily in rates of mood disorders and social impairment. Oppositional defiant disorder was a significant correlate of adverse family and social outcomes when comorbid disorders (including conduct disorder) were controlled.Conclusions: These results support the validity of the oppositional defiant disorder diagnosis as a meaningful clinical entity independent of conduct disorder and highlight the extremely detrimental effects of oppositional defiant disorder on multiple domains of functioning in children and adolescents.