European Child & Adolescent Psychiatry

, Volume 28, Issue 10, pp 1385–1393 | Cite as

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

  • Nuria de la OsaEmail author
  • Eva Penelo
  • Jose Blas Navarro
  • Esther Trepat
  • Lourdes Ezpeleta
Original Contribution


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.


Dimensional ODD Preschoolers Subthreshold 



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.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Unitat D’Epidemiologia i de Diagnòstic en Psicopatologia del DesenvolupamentUniversitat Autònoma de BarcelonaBarcelonaSpain
  2. 2.Departament de Psicologia Clínica i de la SalutUniversitat Autònoma de BarcelonaBarcelonaSpain
  3. 3.Departament de Psicobiologia i Metodologia de les Ciències de la SalutUniversitat Autònoma de BarcelonaBarcelonaSpain
  4. 4.Institut de PsicologiaBarcelonaSpain

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