Oppositional Defiant Disorder
Oppositional defiant disorder (ODD) is when children and teens show angry and defiant behaviors more than their peers. The behavior is not due to psychosis, substance use, or a mood disorder.
ODD impacts school, work, and family situations. Treatment can help.
The cause is not known. It may be a mix of genes, family, and social factors.
A chemical imbalance in the brain may be responsible for ODD.
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This problem is more common in children with long-term obesity. Other things that may raise a child's risk are:
- Family members with the same problems
- A parent who has problems with:
- Substance misuse
- Birth parent used alcohol, smoked, or had a poor diet while pregnant
- Problems with how the family works at home
- Past child abuse
- Lack of parent attention
A child's problems start at around 8 years old. They tend to get worse as time goes on.
Children with ODD often:
- Argue with adults
- Lose their tempers
- Do not follow what an adult tells them to do
- Annoy others on purpose
- Are angry, bitter, and easily annoyed
- Are spiteful or want to get back at others
- Blame others for their own mistakes
- Have low self-esteem
The doctor will ask about the child's symptoms and past health. Parents, teachers, and relatives may be asked about the child's problems. A physical exam will be done. This is often enough to make the diagnosis.
The goal is to stop problem behaviors. Options are:
- Parent training
- Individual or group counseling—to help children learn to express and control anger
- Social skills training—to help a child get along better with peers
- Medicines used with other treatments—to help ease certain symptoms, such as mood swings
Early treatment for behavioral problems may lower the risk of ODD.
- Gorman DA, Gardner DM, et al. Canadian guidelines on pharmacotherapy for disruptive and aggressive behaviour in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, or conduct disorder. Can J Psychiatry. 2015;60(2):62-76.
- Oppositional defiant disorder. American Academy of Child & Adolescent Psychiatry website. Available at: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-With-Oppositional-Defiant-Disorder-072.aspx.
- Oppositional defiant disorder. Boston Children's Hospital website. Available at: https://www.childrenshospital.org/conditions/oppositional-defiant-disorder.
- Oppositional defiant disorder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/oppositional-defiant-disorder.
- Oppositional defiant disorder (ODD). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/pediatrics/mental-disorders-in-children-and-adolescents/oppositional-defiant-disorder-odd.
- Adrian Preda, MD
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