14 TPC Digest Youth who are diagnosed with oppositional defiant disorder (ODD) experience symptoms including frustration, anger, and irritability, which can cause defiance and issues with authority figures. The symptoms of ODD occur across multiple environments including the home and school. Children and adolescents who are diagnosed with obsessive-compulsive disorder (OCD) act on obsessions by performing compulsions or repetitive ritualistic behaviors. Oftentimes, the settings in which children and adolescents feel the urge to complete compulsions are inappropriate and restrictive, resulting in frustration and anger. This frustration and anger can be misdirected and viewed as defiance directed at authority figures, including parents and teachers. OCD is considered a highly comorbid disorder, with literature suggesting strong co-occurrence with ODD. Exploring the symptoms of frustration and anger related to obsessions and compulsions experienced by youth who have been diagnosed with ODD will provide insight into the comorbidity of these disorders and the potential for misdiagnosis. Consideration of the co-occurrence of ODD and OCD is critical for assessment and accurate diagnosis and will influence the trajectory of treatment. In this study, scores for symptoms and severity of ODD and OCD were retrospectively collected from the patient charts of 179 children and adolescents who had been previously diagnosed with ODD. The ODD symptoms collected in this study included annoyance, anger, resentfulness, and spitefulness or vindictiveness. The OCD symptom that was collected referred to frustration or anger related to obsessions and compulsions. The findings of this study indicated significant associations between frustration and anger related to OCD symptoms (i.e., obsessions and compulsions) and the annoyance and anger symptoms of ODD. Furthermore, OCD severity predicted increased scores of ODD severity and symptoms. This study sought to assess the relationships between symptoms of anger and frustration that were associated with ODD and OCD. Additionally, analysis of severity ratings of ODD and OCD provided further insight into the co-occurrence of these disorders. The premise of this article was that the inability to act on obsessions and compulsions results in increased anger and frustration, which can contribute to a diagnosis of ODD. Children and adolescents experiencing comorbidity of these disorders or who have been misdiagnosed with ODD as opposed to OCD are at risk for ineffective treatment. In this study, we highlight the need for thorough clinical assessment completed by clinicians working with youth who are exhibiting anger or frustration related to these disorders. Specifically, we discuss areas to consider when evaluating children and adolescents in order to recognize the diagnostic differences between ODD and OCD. Lastly, the article provides resources for the parents and guardians of youth who are diagnosed with either of these disorders. Accurate diagnosis of these disorders is imperative for youth to receive the necessary treatment that will impact their daily functioning. Nelson Handal, MD, DFAPA, is Founder, Chairman, and Medical Director for Dothan Behavioral Medicine Clinic and Harmonex Neuroscience Research. Emma Quadlander-Goff, PhD, NCC, LPC, is a clinical researcher at Harmonex Neuroscience Research and an assistant professor at Troy University. Laura Handal Abularach, MD, is a researcher at Harmonex Neuroscience Research and PGY-1 Psychiatry Resident at Louisiana State University. Sarah Seghrouchni, BS, is a research assistant at Alabama College of Osteopathic Medicine. Barbara Baldwin, MS, is Director of Clinical Research at Harmonex Neuroscience Research. Correspondence may be addressed to Emma Quadlander-Goff, 408 Healthwest Dr., Dothan, AL 36303, equadlander@troy.edu. Nelson Handal, Emma Quadlander-Goff, Laura Handal Abularach, Sarah Seghrouchni, Barbara Baldwin Comorbidity of Obsessive-Compulsive Disorder in Youth Diagnosed With Oppositional Defiant Disorder 14
RkJQdWJsaXNoZXIy NDU5MTM1