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Helping Clinicians to Detect ODD in Children with ADHD in Clinical Settings


The objectives of this study were to provide a basic tool for pediatricians or other physicians to suspect and detect ODD in children with ADHD and to distinguish the symptomatic profile of ODD from ADHD. 101 subjects with ADHD, 83 with both ADHD and ODD and 342 controls aged 8 to 15 years were included in the study. A semi-structured interview was performed for evaluation of psychiatric diagnoses. Both parents and teachers completed DSM-IV Disruptive Behavior Disorders Rating Scale. We found differences among all three diagnostic subsamples in two-by-two analyses for all dimensions (Inattention, Hyperactivity/Impulsivity and ODD) both according to parent and teacher reports (p < 0.03 for all analyses). Based on parental ODD scores, ROC Curve analyses between ‘only ADHD’ and ‘ADHD+ODD’ groups showed that AUC was equal 0.80 (95%CI = 0.73–0.86) and the best cutoff point for ODD diagnosis in the ADHD subjects was 0.68. This study demonstrates the presence of a basic tool for detection and suspicion of ODD in children with ADHD for primary care clinicians or pediatricians in clinical settings. Findings also indicate that patients with ODD and ADHD have more severe inattention, hyperactivity/impulsivity and oppositional symptoms than those with only ADHD have.

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Correspondence to Nurhak Dogan.

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Conflict of Interest

Eyüp Sabri Ercan is on advisory boards for Sanofi Turkey. Luis Augusto Rohde has received grant or research support from, served as a consultant to, and served on the speakers’ bureau of Eli Lilly and Co., Janssen, Medice,Novartis, and Shire. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Luis Rohde have received unrestricted educational and research support from the following pharmaceutical companies: Eli Lilly and Co., Janssen, and Novartis. Luis Rohde has also received authorship royalties from Oxford Press and ArtMed and travel grants from Shire to take part in the 2018 APA annual meeting and from Novartis to take part of the 2017 WFADHD meeting. The other authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the Ethical Committee of Ege University. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration.

Informed Consent

Written informed consent for this research was obtained from parents.

Research Involving Human Participants and/or Animals

This study involves child participants and investigates diagnostic process of ODD in children with ADHD.

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Tahillioğlu, A., Dogan, N., Ercan, E.S. et al. Helping Clinicians to Detect ODD in Children with ADHD in Clinical Settings. Psychiatr Q 92, 821–832 (2021).

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  • ODD
  • Oppositional defiant disorder
  • Clinician assessment
  • Diagnosis
  • ADHD