The Effects of ODD Comorbidity on Internalizing and Externalizing Symptoms in Children and Adolescents with ADHD

Aim: Oppositional defiant disorder (ODD) is the most common psychiatric disorder comorbid with attention deficit hyperactivity disorder (ADHD). This study aims to identify the areas of difficulty and to evaluate the internalizing and externalizing symptoms of children and adolescents diagnosed with ADHD with and without ODD comorbidity. Materials and Methods: The study was conducted with 51 children and adolescents with ADHD and 51 children and adolescents with ADHD+ODD. The Strengths and Difficulties Questionnaire (SDQ) was used to determine the areas of difficulty experienced by the children, and the Revised Child Anxiety and Depression scale was used to assess depression and anxiety levels, rated separately by the children and their parents. Results: In children's statements, emotional problems, peer problems, internalization, total difficulty, and de-pression scores were significantly higher in the ADHD+ODD group compared to the ADHD group (p<0.05). In the ADHD+ODD group, behavioral problems, attention-deficit/hyperactivity, externalization, total difficulties, anxiety, and depression scores were found to be higher on the parental scales compared to the ADHD group. In the binary logistic regression analysis examining the predictive factors related to the presence of ODD comorbidity, it was found that externalizing symptoms such as conduct problems and attention-deficit/hyperactivity obtained from the parent-rated SDQ sub-scales predicted ODD. Conclusion: Our findings suggest that the presence of ODD comorbidity leads to an increase in internalizing and externalizing symptoms in children with ADHD and that children's and parents' reports of subjective experiences may differ from each other.

Dergi

NAMIK KEMAL MEDICAL JOURNAL

Yıl

2026

Cilt

14

Sayı

1

Sayfa

70-77

eISSN

2587-0262

DOI

10.4274/nkmj.galenos.2025.04696

WoS UID

WOS:001710245800001