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The Disruptive Behavior Disorders are the most common psychiatric disorder of childhood, with a prevalence of 4-9% of the entire pediatric population.  The incidence is particularly high in patients with below average IQ, approximately 3-4 times more common than in children with normal IQ.  There are often comorbid psychiatric diagnoses, including mood disorders, substance abuse, and ADHD.  It is estimated that approximately two-thirds of children with ADHD will also have a disruptive behavior disorder diagnosed.  The Disruptive Behavior Disorders can be classified according to DSM-IV into conduct disorder, oppositional defiant disorder, and disruptive behavior, NOS (18,19).

  I. Conduct Disorder ---

A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three or more of the following criteria in the past 12 months, with at least one criterion present in the past 6 months:

• Aggression to people and animals
• Destruction of property
• Deceitfulness or theft
• Serious violations of rules

The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning, and criteria is not met for antisocial personality disorder if the patient is 18 years of age.

  II.  Oppositional Defiant Disorder (ODD) ---

A pattern of negativistic,hostile, and defiant behavior lasting at least 6 months, during which four or more of the following are present:

• Often loses temper
• Often argues with adults
• Often actively defies or refuses to comply with adults’ requests or rules
• Often deliberately annoys people
• Often blames others for his or her mistakes or misbehavior
• Is often touchy or easily annoyed by others
• Is often angry and resentful
• Is often spiteful or vindictive

       The disturbance in behavior causes clinically significant impairment in social, academic, or   

        occupational functioning.

       The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder

       Criteria are not met for Conduct Disorder or Antisocial Personality Disorder(if older than 18)

  III. Disruptive Behavior Disorder, NOS ---

This category is for disorders characterized by conduct or oppositional defiant behaviors that do not meet the criteria for Conduct Disorder or Oppositional Defiant Diorder.

By: Todd M. Felix

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