Treatment of Childhood Oppositional Defiant Disorder

Abstract

Disruptive behavior disordersCase You are seeing a previously healthy 4-year-old William in your office for behavior problems at preschool and at home. This is the third preschool he has attended after having been asked to leave his prior two for out of control behavior. His mother reports that he refuses to comply with her directions and will argue with her when confronted. He frequently is involved in physical altercations in his preschool class. He tells his teacher at school and his mother that they are Bstupid^and that he hates them. His mother has brought William in today because she feels that she is at her Bwit's end^and his teacher thinks Bhe needs to be medicated.^Vanderbilt scales from his mother and teacher indicate attention-deficit hyperactivity disorder, combined inattentive, and hyperactive type. You note that the oppositional defiant disorder (ODD) screen is positive for both mother and teacher. On further discussion, his mother states that she and William's father are divorced and that they differ significantly in their parenting styles. She admits she has mostly Bgiven up^on correcting her son's behavior, but his father is extremely strict and Bon him all the time.Ŷ ou discuss the importance of consistent parenting with the mother and recommend that the child and both parents establish care with a mental health professional for Parent Management Training (PMT). You also provide recommendations for parenting books. You discuss with William's mother that you would consider starting a stimulant attention-deficit hyperactivity disorder (ADHD) medication if behavioral interventions do not improve his functioning and plan to see him back in 3 months.

High-dose eicosapentaenoic acid (EPA) improves attention and vigilance in children and adolescents with attention deficit hyperactivity disorder (ADHD) and low endogenous EPA levels

“…As 51 out of 92 participants had comorbid ODD, and children with ADHD and ODD tend to be generally less responsive to pharmacological treatment 28 , we tested whether this improvement in attention was present in a subgroup analysis of these 51 participants; and indeed, we found that, as in the whole group, youth on EPA improved more than youth on placebo in focused attention ( ES = 0.66, CI = 0.07 to 1.23, p = 0.025).…”

Generalized structural equation modeling: Symptom heterogeneity in attention-deficit/hyperactivity disorder leading to poor treatment efficacy

“…The treatment effects on ODD depend on how the underlying comorbid ADHD is treated. Usually, the core symptoms of ODD are not amenable to pharmacotherapy alone[ 32 ]. For children with ADHD with ODD, treatments with only pharmacotherapy for inattention alone always remains noneffective for these ODD symptoms[ 33 , 34 ].…”