J Korean Neuropsychiatr Assoc.  2019 Nov;58(4):331-338. 10.4306/jknpa.2019.58.4.331.

Assessment of Functional Impairments in Male Children and Adolescents with Attention-Deficit/Hyperactivity Disorder and Oppositional Defiant Disorder

• Ryu Y
• Lee SI
• Lee J
• Lee AR
• Kim SG
• Jung HY

• KMID: 2465053
• DOI: http://doi.org/10.4306/jknpa.2019.58.4.331

Abstract

OBJECTIVES
Many studies have demonstrated comorbidities and overlapping symptoms in attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). The purpose of this study was to examine the functional impairment in subjects with ADHD, ODD, and in those with both ADHD and ODD.
METHODS
172 male subjects, aged 6 to 15 years old, were enrolled in this study. Based on diagnoses made by applying the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (K-SADS-PL), the subjects were categorized into four groups: ADHD group (n=64), ODD group (n=17), ADHD+ODD group (n=28), and control group (n=63). The Child and Adolescent Functioning Impairment Scale (CAFIS) was used to measure the functional impairment of the subjects. CAFIS consists of four subscales : Family relationship, Teacher relationship, Peer relationship, and Academic achievement scales. A high CAFIS score implies high functional impairment. Analysis of covariance was conducted to compare the scores between the four groups.
RESULTS
Both the ODD and the ADHD+ODD groups had significantly high scores for Parent relationship compared to that of the ADHD group. Compared to the control group, both the ADHD and the ADHD+ODD group had significantly higher scores for Peer relationship and Academic achievement, whereas, the ODD group showed no significant difference from the control group on those two subscales.
CONCLUSION
The present study showed that subjects with ADHD and ODD have different functional impairment characteristics. The subjects' relationships with their parents were worsened by the presence of ODD. Peer relationships and Academic achievements were significantly affected by the presence of ADHD.

Keyword

Attention-deficit/hyperactivity disorder; Oppositional defiant disorder; Comorbidity; Functional impairment; Child and Adolescent Functioning Impairment Scale (CAFIS)

MeSH Terms

Adolescent*
Attention Deficit and Disruptive Behavior Disorders*
Child*
Comorbidity
Diagnosis
Family Relations
Humans
Male*
Mood Disorders
Parents
Weights and Measures

Figure

• 

  Fig. 1 Comparisons of CAFIS-parent between participants with ADHD, ODD, ADHD+ODD, and non-affected controls. Post hoc Scheffé test. * : p<0.01, ** : p<0.001. ADHD : Attention-deficit/hyperactivity disorder, ODD : Oppositional defiant disorder, CAFIS : Child and Adolescents Functioning Impairment Scale.

• 

  Fig. 2 Comparisons of CAFIS-teacher between participants with ADHD, ODD, ADHD+ODD, and non-affected controls. Post hoc Scheffé test. * : p<0.01, ** : p<0.001. ADHD : Attention-deficit/hyperactivity disorder, ODD : Oppositional defiant disorder, CAFIS : Child and Adolescents Functioning Impairment Scale.

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