Co-occurence and Differentiation of Oppositional Defiant and Mood Disorders among Children and Adolescents

Oppositional defiant disorder (ODD) frequently co-occurs with depression in youth, and it has been proposed that ODD Angry/Irritable Mood symptoms predict depression in these youth. Another explanation is that the ODD Angry/Irritable Mood dimension is a component of a broader emotion dysregulation syndrome. This study examined the relationship of ODD Angry/Irritable Mood symptoms with depression, and the Child Behavior Check List (CBCL) Dysregulation Profile with co-occurring ODD and depression in clinic-referred youth. Of 310 youth referred to an outpatient clinic, 86 were diagnosed with ODD without depression, and 78 were diagnosed with co-occurring ODD and depression. These groups did not differ in number of ODD Angry/Irritable Mood symptoms, and ODD affective symptoms showed a low correlation with youth-reported depression and parent- reported CBCL Anxious/Depressed symptoms. Logistic regression analysis with ODD Angry/Irritable Mood symptoms did not differentiate youth who were diagnosed with ODD without depressive disorder from youth who were diagnosed with co-occurring ODD and depression. The 55 youth who fit the CBCL - Dysregulation Profile were more likely to be diagnosed with depression than youth who did not fit the profile. Logistic regression analysis with this profile differentiated youth with co-occurring ODD and depression from youth diagnosed with ODD without co-occurring depression. Present results did not support the hypothesis that ODD Angry/Irritable Mood symptoms are differentially associated with depression in clinic-referred youth with ODD. However, the results did support the hypothesis that the parent-report CBCL dysregulation profile differentiates youth with co-occurring ODD and depression from ODD youth without depression.