Serra-Pinheiro Maria Antonia, Schmitz Marcelo, Mattos Paulo, Souza Isabella
Instituto de Psiquiatria, UFRJ, Brazil.
Braz J Psychiatry. 2004 Dec;26(4):273-6. doi: 10.1590/s1516-44462004000400013. Epub 2005 Feb 23.
Oppositional defiant disorder (ODD) is an independent diagnostic entity but it is frequently studied in conjunction with Attention-Deficit Hyperactivity Disorder (ADHD) or Conduct Disorder (CD). The purpose of this paper is to review the extant evidence, through the PubMed database, on the neurobiological correlates of oppositional defiant disorder and also describe the familiar and school functioning, comorbidities, prognosis and therapeutic options for oppositional defiant disorder. Evidence of hormonal, genetic and neuro-functional findings in oppositional defiant disorder, correlation with the family, school relations and performance, and the association with mood and anxiety and disruptive disorders are described. The risk of an evolution to conduct disorder and of persistence of the oppositional defiant disorder symptoms is depicted. A review of the effect of Cognitive-Behavioral Therapy and medication is presented. Analysis of the available evidence shows that the impact of oppositional defiant disorder should not be ignored and it should be properly addressed. The effect of treatment for oppositional defiant disorder on the long-term outcome of patients still needs to be addressed.
对立违抗性障碍(ODD)是一种独立的诊断实体,但它经常与注意力缺陷多动障碍(ADHD)或品行障碍(CD)一起进行研究。本文的目的是通过PubMed数据库回顾关于对立违抗性障碍神经生物学相关性的现有证据,并描述对立违抗性障碍患者的家庭和学校功能、共病情况、预后及治疗选择。文中描述了对立违抗性障碍中激素、遗传和神经功能方面的研究结果,以及与家庭、学校关系和表现的相关性,还有与情绪、焦虑及破坏性行为障碍的关联。阐述了发展成品行障碍的风险以及对立违抗性障碍症状持续存在的情况。还介绍了认知行为疗法和药物治疗的效果。对现有证据的分析表明,对立违抗性障碍的影响不容忽视,应妥善应对。对立违抗性障碍的治疗对患者长期预后的影响仍有待探讨。