BACKGROUND:Oppositional defiant disorder (ODD) is a leading cause of referral for youth mental health services; yet, many uncertainties exist about ODD given it is rarely examined as a distinct psychiatric disorder. We examined the lifetime prevalence, onset, persistence, and correlates of ODD. METHODS:Lifetime prevalence of ODD and 18 other DSM-IV disorders was assessed in a nationally representative sample of adult respondents (n = 3,199) in the National Comorbidity Survey Replication. Retrospective age-of-onset reports were used to test temporal priorities with comorbid disorders. RESULTS:Lifetime prevalence of ODD is estimated to be 10.2% (males = 11.2%; females = 9.2%). Of those with lifetime ODD, 92.4% meet criteria for at least one other lifetime DSM-IV disorder, including: mood (45.8%), anxiety (62.3%), impulse-control (68.2%), and substance use (47.2%) disorders. ODD is temporally primary in the vast majority of cases for most comorbid disorders. Both active and remitted ODD significantly predict subsequent onset of secondary disorders even after controlling for comorbid conduct disorder (CD). Early onset (before age 8) and comorbidity predict slow speed of recovery of ODD. CONCLUSIONS:ODD is a common child- and adolescent-onset disorder associated with substantial risk of secondary mood, anxiety, impulse-control, and substance use disorders. These results support the study of ODD as a distinct disorder. Prospective and experimental studies are needed to further delineate the temporal and causal relations between ODD and related disorders.

译文

背景:抗逆性疾病(ODD)是转介青年心理健康服务的主要原因。然而,由于ODD很少被视为一种独特的精神病,因此存在许多不确定性。我们检查了ODD的终生患病率,发病率,持续性和相关性。
方法:在全国合并症调查复制中,在全国代表性的成年受访者(n = 3,199)中评估了ODD和其他18种DSM-IV疾病的终生患病率。回顾性发病年龄报告用于测试合并症的时间优先级。
结果:ODD的终生患病率估计为10.2%(男性= 11.2%;女性= 9.2%)。一生中有ODD的患者中,有92.4%符合至少一种其他一生中DSM-IV疾病的标准,包括:情绪(45.8%),焦虑症(62.3%),冲动控制(68.2%)和药物滥用(47.2%)失调。对于大多数合并症,在大多数情况下,ODD在时间上是主要的。即使在控制了共病行为障碍(CD)之后,活动性ODD和缓解性ODD仍可显着预测继发性疾病的继发。早发(8岁之前)和合并症预示着ODD的恢复速度较慢。
结论:ODD是一种常见的儿童和青少年期疾病,伴有继发性情绪,焦虑,冲动控制和药物滥用疾病的重大风险。这些结果支持了ODD作为一种独特疾病的研究。需要进行前瞻性和实验研究,以进一步描述ODD与相关疾病之间的时间和因果关系。

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