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Prevalence, comorbidity, functioning and long-term effects of subthreshold oppositional defiant disorder in a community sample of preschoolers

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Abstract

To study the prevalence of subthreshold oppositional defiant disorder (ST ODD)—less than 4 symptoms, but nonetheless an impairing form of oppositional defiant disorder (ODD)—its coexistence with other homotypic externalizing and heterotypical internalizing problems in children and associated impairment, as well as the long-term effect of this condition. A population-based sample of 622 preschoolers (5.0% boys) was followed up from preschool to preadolescence. Parents were interviewed when the children were 3, 6 and 9 years old with the Diagnostic Interview for Preschoolers/Children and Adolescents versions following DSM-5 and the children’s functioning was assessed by trained clinicians. ST ODD diagnosis is highly prevalent (19.4–25.5%), highly comorbid [homo- (1.9–18.4%) and heterotypical (5.8–23.7%)], resulting in functional impairment across child development in a similar way for both genders. ST is also a risk factor condition that predicts the presence of psychological problems and impairment in childhood and preadolescence from preschool age. A broader clinical assessment and intervention similar to that provided full syndrome cases is needed for children presenting subthreshold forms of ODD.

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Acknowledgements

Funding was provided by the Spanish Ministry of Economy and Competitiveness grants PSI2012-32695 and PSI2015-63965-R (MINECO/FEDER). Thank you to the Secretaria d’Universitats i Recerca, Departament d’Economia i Coneixement de la Generalitat de Catalunya (2014 SGR 312). We would also like to acknowledge all the schools, families and children involved in this research.

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Authors and Affiliations

  1. Unitat D’Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Barcelona, Spain

    Nuria de la Osa, Eva Penelo, Jose Blas Navarro, Esther Trepat & Lourdes Ezpeleta

  2. Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain

    Nuria de la Osa & Lourdes Ezpeleta

  3. Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain

    Eva Penelo & Jose Blas Navarro

  4. Institut de Psicologia, Barcelona, Spain

    Esther Trepat

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  1. Nuria de la Osa
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Correspondence to Nuria de la Osa.

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de la Osa, N., Penelo, E., Navarro, J.B. et al. Prevalence, comorbidity, functioning and long-term effects of subthreshold oppositional defiant disorder in a community sample of preschoolers. Eur Child Adolesc Psychiatry 28, 1385–1393 (2019). https://doi.org/10.1007/s00787-019-01300-0

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