Long-acting methylphenidate has an effect on aggressive behavior in children with attention-deficit/hyperactivity disorder. Clinical symptoms and performance on the continuous performance test in children with attention deficit hyperactivity disorder between subtypes: a natural follow-up study for 6 months Source-Specific Oppositional Defiant Disorder Among Inner-City Children: Prospective Prediction and Moderation Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD. The effect of methylphenidate on oppositional defiant disorder comorbid with attention deficit/hyperactivity disorder. Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder: the Multimodal Treatment Study of children with Attention-deficit/hyperactivity disorder. Preschool children with disruptive behavior: three-year outcome as a function of adaptive disability. Dimensions of oppositional defiant disorder in 3-year-old preschoolers. An efficacy study of a combined parent and teacher management training programme for children with ADHD A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. A Pilot Study of Methyiphenidate, Clonidine, or the Combination in ADHD Comorbid with Aggressive Oppositional Defiant or Conduct Disorder Clinical evaluation of subjective and objective changes in motor activity and attention in children with attention-deficit/hyperactivity disorder in a double-blind methylphenidate trial. Enhancing Behavioral and Social Skill Functioning in Children Newly Diagnosed with Attention-Deficit Hyperactivity Disorder in a Pediatric Setting Combining Parent and Child Training for Young Children with ADHD Clinical efficacy of methylphenidate in conduct disorder with and without attention deficit hyperactivity disorder. A Randomized Trial Examining the Effects of Aerobic Physical Activity on Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children Efficacy and safety of mixed amphetamine salts extended release (adderall XR) in the management of oppositional defiant disorder with or without comorbid attention-deficit/hyperactivity disorder in school-aged children and adolescents: A 4-week, multicenter, randomized, double-blind, parallel-group,
INTRODUCTION Aggression is frequently observed in children and adolescents with attention-deficit/hyperactivity disorder ( ADHD ) . The aim of this study was to assess the efficacy with regard to oppositional and aggressive behavior of a new long-acting methylpheni date preparation ( Medikinet retard , MPH-MR ) , with equal portions of the immediate-release and the sustained-release active substance , and especially to look at correlations between either teacher or parent assessment of aggression and ADHD sub-symptomatology . METHODS Eighty five children and adolescents ( 6 - 16 years ) were investigated in a double-blind , r and omized , clinical trial over 5 weeks under a treatment with MPH-MR  using symptom checklists for ADHD , oppositional-defiant and conduct disorder according to the Diagnostic and Statistical Manual of Mental Disorders , 4th edition ( DSM-IV ) . RESULTS A total of 64.9 % of the children showed oppositional defiant disorder/conduct disorder ( ODD/CD ) symptoms . A statistically significant effect was found in the group treated with MPH ( verum-group ) . On the basis of Cohen 's criteria , high effects were found for aggressive symptoms in school ( d = 1.0 ) , but not in the afternoon ( d = 0.4 ) . There were also lower effect sizes for more severe aggressive symptoms . We found characteristic correlations between ODD/CD symptoms and the ADHD subscale hyperactivity/impulsivity compared to the subscale inattention . CONCLUSIONS Long-acting MPH is effective in the treatment of oppositional-defiant and aggressive behavior , especially concerning milder symptoms . The expected correlation between impulsivity and aggressiveness could be confirmed Background The aims of this study were to determine the time course of improvements in attention deficit hyperactivity disorder ( ADHD ) clinical symptoms and neurocognitive function in a realistic clinical setting , and the differences in ADHD symptom improvement using different classifications of ADHD subtypes . Methods The Child Behavior Checklist ( CBCL ) was completed by parents of ADHD children at the initial visit . The  computerized Continuous Performance Test ( CPT ) , Swanson , Nolan , and Pelham , and Version IV Scale for ADHD ( SNAP-IV ) , and  ADHD Rating Scale ( ADHD-RS ) were performed at baseline , one month , three months , and six months later , respectively . Patient care including drug therapy was performed at the discretion of the psychiatrist . The ADHD patients were divided into DSM-IV subtypes ( Inattentive , Hyperactive-impulsive and Combined type ) , and were additionally categorized into aggressive and non-aggressive subtypes by aggression scale in CBCL for comparisons . Results There were 50 ADHD patients with a mean age of 7.84 ± 1.64 years ; 15 of them were inattentive type , 11 were hyperactive-impulsive type , and 24 were combined type . In addition , 28 of the ADHD patients were grouped into aggressive and 22 into non-aggressive subtypes . There were significant improvements in clinical symptoms of hyperactivity and inattention , and impulsivity performance in CPT during the 6-month treatment . The clinical hyperactive symptoms were significantly different between ADHD patients sub-grouping both by DSM-IV and aggression . Non-aggressive patients had significantly greater changes in distraction and impulsivity performances in CPT from baseline to month 6 than aggressive patients . Conclusions We found that ADHD symptoms , which included impulsive performances in CPT and clinical inattention and hyperactivity dimensions , had improved significantly over 6 months under pragmatic treatments . The non-aggressive ADHD patients might have a higher potential for improving in CPT performance than aggressive ones . However , it warrant further investigation whether the different classifications of ADHD patients could be valid for predicting the improvements in ADHD patients ' clinical symptoms and neurocognitive performance We examined prospect i ve prediction from  parent- and teacher-reported oppositional defiant disorder ( ODD ) symptoms to parent-reported ODD , conduct disorder ( CD ) , major depressive disorder ( MDD ) , and generalized anxiety disorder symptoms and whether child executive functioning abilities moderated these relations among an urban , low-income sample of first- to third- grade children ( N = 87 ) .  Time 1 parent-reported ODD predicted each Time 2 outcome . Time 1 teacher-reported ODD predicted Time 2 CD and MDD symptoms . After controlling for Time 1 co-occurring symptoms , only prediction from Time 1 teacher-reported ODD to CD and MDD symptoms remained significant . Child executive functioning abilities moderated relations between Time 1 parent-reported ODD and Time 2 ODD , and Time 1 teacher-reported ODD and Time 2 CD and MDD . Among children with better executive functioning abilities , higher Time 1 ODD was associated with higher Time 2 symptoms Children diagnosed with attention-deficit/hyperactivity disorder ( ADHD ; n = 142 ) were prospect ively monitored into adolescence ( 13 - 18 years old ) to evaluate their risk for elevated substance use relative to same-aged adolescents without ADHD ( n = 100 ) . Prob and s reported higher levels of alcohol , tobacco , and illicit drug use than did controls . Group differences were apparent for alcohol symptom scores but not for alcohol or marijuana disorder diagnoses . Within prob and s , severity of childhood inattention symptoms predicted multiple substance use outcomes : childhood oppositional defiant disorder/conduct disorder ( ODD/CD ) symptoms predicted illicit drug use and CD symptoms . Persistence of ADHD and adolescent CD were each associated with elevated substance use behaviors relative to controls . Further study of the mediating mechanisms that explain risk for early substance use and abuse in children with ADHD is warranted OBJECTIVE To assess the effect of methylpheni date on the diagnosis of oppositional-defiant disorder ( ODD ) comorbid with attention-deficit hyperactivity disorder ( ADHD ) . METHOD We conducted an open-label study in which 10 children and adolescents with a dual diagnosis of ODD and ADHD were assessed for their ODD symptoms and treated with methylpheni date . At least one month after ADHD symptoms were under control , ODD symptoms were reevaluated with the Parent form of the Children Interview for Psychiatric Syndromes ( P-ChIPS ) . RESULTS Nine of the 10 patients no longer fulfilled diagnostic criteria for ODD after they were treated with methylpheni date for ADHD . CONCLUSION Methylpheni date seems to be an effective treatment for ODD , as well as for ADHD itself . The implication s for the treatment of patients with ODD not comorbid with ADHD needs further investigation BACKGROUND Intent-to-treat analyses of the study revealed that medication management , alone or combined with intensive behavioral treatment , was superior to behavioral treatment and community care in reducing attention-deficit/hyperactivity disorder ( ADHD ) symptoms ; but only combined treatment showed consistently greater benefit than community care across other outcome domains ( disruptive and internalizing symptoms , achievement , parent-child relations , and social skills ) . We examine response patterns in subgroups defined by baseline variables ( moderators ) or variables related to treatment implementation ( mediators ) . METHODS We reconducted r and om-effects regression ( RR ) analyses , adding factors defined by moderators ( sex ,  prior medication use  ,  comorbid disruptive or anxiety disorder  , and public assistance ) and a mediator ( treatment acceptance/attendance ) . RESULTS Study outcomes ( N = 579 ) were upheld in most moderator subgroups ( boys and girls , children with and without prior medication , children with and without comorbid disruptive disorders ) . Comorbid anxiety disorder did moderate outcome ; in participants without anxiety , results paralleled intent-to-treat findings . For those with anxiety disorders , however , behavioral treatment yielded significantly better outcomes than community care ( and was no longer statistically different from medication management and combined treatment ) regarding ADHD-related and internalizing symptoms . In families receiving public assistance , medication management yielded decreased closeness in parent-child interactions , and combined treatment yielded relatively greater benefits for teacher-reported social skills . In families with high treatment acceptance/attendance , intent-to-treat results were upheld . Acceptance/attendance was particularly important for medication treatments . Finally , two thirds of children given community care received stimulants . Behavioral treatment did not significantly differ from , but medication management was superior to , this subgroup . CONCLUSIONS Exploratory analyses revealed that our study ( the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder [ MTA ] ) results were confirmed across most baseline variables and treatment acceptance/attendance . In children with ADHD plus anxiety , behavioral treatment surpassed community care and approached medication-based treatments regarding parent-reported ADHD symptoms A significant discrepancy between intelligence and daily adaptive functioning , or adaptive disability ( AD ) , has been previously found to be a associated with significant psychological morbidity in preschool children with disruptive behavior ( DB ) . The utility of AD as a predictor of later developmental risks was examined in a 3-year longitudinal study of normal ( N = 43 ) and DB preschool children . The DB children were grouped into those with AD ( DB+AD ; N = 28 ) and those without AD ( DB-only ; N = 98 ) . All children were followed with annual evaluations to the end of second grade . Both DB groups demonstrated substantial and pervasive psychological and educational morbidity at 3-year follow-up . In comparison to DB-only children , DB+AD children had more symptoms of attention-deficit hyperactivity disorder ( ADHD ) and conduct disorder ( CD ) , more severe and pervasive behavior problems at home , more parent-rated externalizing and internalizing , and lower academic competence and more behavioral problems at school . Parents of DB+AD children also reported greater parenting stress than did parents in the other groups . A significant contribution of AD to adverse outcomes in the DB group remained on some measures even after controlling for initial severity of DB . AD also contributed significantly to CD symptoms at follow-up after controlling for initial DB severity and initial CD symptoms . The results corroborate and extend earlier findings of the utility of AD as a risk indicator above severity of DB alone . They also imply that AD in the context of normal intellectual development may arise from both the deficient self-regulation associated with ADHD and from disrupted parenting . with exposure to kindergarten moderating these adverse effects BACKGROUND To test the factor structure of oppositional defiant disorder ( ODD ) symptoms and to study the relationships between the proposed dimensions and external variables in a community sample of preschool children . METHOD A sample of 1,341 3-year-old preschoolers was r and omly selected and screened for a double-phase design . In total , 622 families were assessed with a diagnostic semi-structured interview and question naires on psychopathology , temperament and executive functioning completed by parents and teachers . RESULTS Using categorical and dimensional symptoms of ODD it was possible to confirm , cross-informant and cross- method , distinct dimensions for defining the structure of ODD : one made up of irritable and headstrong and the other of negative affect , oppositional behaviour and antagonistic behaviour . Specific associations with DSM-IV disorders were found , and irritable was associated with anxiety disorders , whereas headstrong was associated with disruptive disorders , including aggressive and non-aggressive CD symptoms . Also , negative affect was associated with anxiety disorders and non-aggressive CD symptoms , oppositional behaviour with disruptive disorders and aggressive CD symptoms , and antagonistic behaviours with disruptive disorders and , in boys , with mood disorders . The dimensions correlated with specific scales of psychopathology , temperament and executive functioning . CONCLUSIONS Oppositional defiant disorder is a heterogeneous disorder from preschool age . Different dimensions , with moderate to acceptable reliability and convergent and discriminant validity with other psychological constructs , can be identified early in life Background : Several parent training programmes and behavioural teacher training programmes built on learning theory have been developed for problem prevention and treatment of attention-deficit/hyperactivity disorder ( ADHD ) and /or oppositional defiant disorder ( ODD ) during the last few decades . Group format has often been used for parent training but single-subject design s are more common in teacher training . More studies have focussed on pre-school children than on older children , and a minority have been conducted in public mental health setting s. Aim : This study aim ed to evaluate a combined parent and teacher manual-based group training programme for children with ADHD conducted by the staff at a child and adolescent psychiatric clinic in Sweden . Method : The intervention was a modified version of Barkley 's programme .  Children were r and omized to an Intervention or a Control group .  Sixty-one parents and 68 teachers answered questions about ADHD and ODD symptoms , and about behavioural problems when the study started and at a 3-month follow-up . Results : Results showed that the intervention result ed in a reduction of the number of children who met DSM-IV criteria for ADHD and /or ODD . Effects were more pronounced in the home setting than in the school setting , and were further accentuated when both parents and teachers of the same child took part in the intervention . Teachers with more problematic classroom situations benefited most from the intervention . Conclusion : The programme , “ Strategies in Everyday Life ” , has , in a regular clinical setting , demonstrated promising effects on children 's disruptive behaviour , and a clinical implication was to recommend involving both parents and teachers in the programme BACKGROUND Previous studies have demonstrated the short-term efficacy of pharmacotherapy and behavior therapy for attention-deficit/hyperactivity disorder ( ADHD ) , but no longer-term ( i.e. , > 4 months ) investigations have compared these 2 treatments or their combination . METHODS A group of 579 children with ADHD Combined Type , aged 7 to 9.9 years , were assigned to 14 months of medication management ( titration followed by monthly visits ) ; intensive behavioral treatment ( parent , school , and child components , with therapist involvement gradually reduced over time ) ; the two combined ; or st and ard community care ( treatments by community providers ) . Outcomes were assessed in multiple domains before and during treatment and at treatment end point ( with the combined treatment and medication management groups continuing medication at all assessment points ) . Data were analyzed through intent-to-treat r and om-effects regression procedures . RESULTS All 4 groups showed sizable reductions in symptoms over time , with significant differences among them in degrees of change . For most ADHD symptoms , children in the combined treatment and medication management groups showed significantly greater improvement than those given intensive behavioral treatment and community care . Combined and medication management treatments did not differ significantly on any direct comparisons , but in several instances ( oppositional/aggressive symptoms , internalizing symptoms , teacher-rated social skills , parent-child relations , and reading achievement )  combined treatment proved superior to intensive behavioral treatment and /or community care while medication management did not . Study medication strategies were superior to community care treatments , despite the fact that two thirds of community-treated subjects received medication during the study period . CONCLUSIONS For ADHD symptoms , our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication . Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms , but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes A pilot comparison of the safety and efficacy of methylpheni date ( MPH ) combined with clonidine , clonidine monotherapy , or MPH monotherapy in 6to 16-year-old children diagnosed with attention deficit hyperactivity disorder ( ADHD ) and comorbid aggressive oppositional defiant disorder or conduct disorder was completed . Study design was a 3-month , r and omized , blinded , group comparison with eight subjects per group . No placebo comparison was used . All three treatment groups showed significant improvements in attention deficits , impulsivity , oppositional , and conduct disordered symptoms as assessed by parent and teacher rating scales and laboratory measures . Significant differences among treatment groups were found only on a few measures . Only the clonidine monotherapy group showed significantly decreased fine motor speed . These results suggest the safety and efficacy of clonidine alone or in combination with MPH for the treatment of ADHD and aggressive oppositional and conduct disorders The aim of this study was to determine drug-dependent effects on attention and motor activity in children with attention-deficit/hyperactivity disorder ( ADHD ) in a double-blind methylpheni date ( MPH ) trial using both subjective behavior ratings and objective measures of function . In particular , we were interested in the relationship between changes of those subjective and objective measures . A total of 44 ADHD children with the combined subtype completed a r and omized , double-blind , placebo-controlled , crossover trial with 2 doses of MPH ( 0.25 ; 0.5 mg/kg body weight ) and placebo . In each condition , computerized attention tasks were performed , teacher-behavior ratings were obtained , and actigraph data were collected in both clinical and naturalistic setting s. Trend tests revealed linear effects of MPH dose on actigraph data in the test session ( p = 0.02 ) and at school ( p = 0.001 ) , as well as on sustained attention ( p < 0.001 ) , while inhibitory control showed a quadratic dose-response curve ( p < 0.001 ) . Multivariate regression analyses revealed that changes of both , hyperactive-impulsive symptoms ( 28 % ) and inattentive symptoms ( 23 % ) could be explained by objective changes of motor activity . Thus , for clinical practice , it should be taken into account that behavior ratings of ADHD symptoms seemed to be predominantly influenced by changes of motor activity ABSTRACT . The objective of this study was to evaluate the effectiveness of an 8-week behavioral and social skill ( BSS ) class for children newly diagnosed with attention-deficit hyperactivity disorder ( ADHD ) and their parents , initiating stimulant treatment in primary care . The subjects were 100 children , aged 5 to 12 years , recently diagnosed with ADHD and treated with stimulant medication , and their parents or guardians . Eligible families were r and omly assigned to an intervention group ( IG : n = 59 ) or control group ( CG : n = 41 ) . The BSS function of each child was assessed using DuPaul ’s ADHD Parent Rating Scale ( 18-item ) and Child Attention Profile ( 12-item ) during blinded baseline and follow-up interviews . Parent discipline practice was assessed using a five-item inventory based on Likert-scale ratings during identical periods . Computerized pharmacy records were used to track psychostimulant use over time . IG children exhibited significantly lower parent-rated ADHD symptoms , whereas IG parents reported significantly better and more consistent discipline practice s compared with CG parents across time . No significant differences were found between groups in Child Attention Profile scores across time . Psychostimulant use did not significantly differ between groups across time .  BSS training  was well accepted and seemed to significantly improve BSS functioning among IG children in the home setting only The efficacy of the Incredible Years parent and child training programs is established in children diagnosed with oppositional defiant disorder but not among young children whose primary diagnosis is attention-deficit/hyperactivity disorder ( ADHD ) . We conducted a r and omized control trial evaluating the combined parent and child program interventions among 99 children diagnosed with ADHD ( ages 4–6 ) . Mother reported significant treatment effects for appropriate and harsh discipline , use of physical punishment , and monitoring , whereas fathers reported no significant parenting changes . Independent observations revealed treatment effects for mothers ' praise and coaching , mothers ' critical statements , and child total deviant behaviors . Both mothers and fathers reported treatment effects for children 's externalizing , hyperactivity , inattentive and oppositional behaviors , and emotion regulation and social competence . There were also significant treatment effects for children 's emotion vocabulary and problem-solving ability . At school teachers reported treatment effects for externalizing behaviors and peer observations indicated improvements in treated children 's social competence BACKGROUND Stimulants are not considered appropriate for the treatment of children with conduct disorders ( CDs ) . The postulated differences in stimulant effect between children with attention deficit hyperactivity disorder ( ADHD ) and CD led to the hypothesis that methylpheni date hydrochloride , which is effective in ADHD , would not significantly improve symptoms of CD . METHODS We r and omly assigned 84 children with CD , between the ages of 6 and 15 years , to receive methylpheni date hydrochloride ( up to 60 mg/d ) or placebo for 5 weeks . Behavior was evaluated by parent , teacher , and clinician reports and by direct classroom observations . Two thirds of the children also met criteria for ADHD . RESULTS Contrary to prediction , ratings of antisocial behaviors specific to CD were significantly reduced by methylpheni date treatment . The magnitude of methylpheni date effect indicated meaningful clinical benefit . Partialling out severity of ADHD did not alter the significant superiority of methylpheni date on CD ratings specifically ( P < .001 ) . CONCLUSIONS Methylpheni date has short-term positive effects on children and adolescents with CD . Key aspects of antisocial adjustment appear to be treatment responsive . This effect was independent of severity of the children 's initial ADHD symptoms The goal of this study was to compare the effects of before school physical activity ( PA ) and sedentary classroom-based ( SC ) interventions on the symptoms , behavior , moodiness , and peer functioning of young children ( Mage = 6.83 ) at risk for attention-deficit/hyperactivity disorder ( ADHD-risk ; n = 94 ) and typically developing children ( TD ; n = 108 ) . Children were r and omly assigned to either PA or SC and participated in the assigned intervention 31 min per day , each school day , over the course of 12 weeks . Parent and teacher ratings of ADHD symptoms ( inattention , hyperactivity/impulsivity ) , oppositional behavior , moodiness , behavior toward peers , and reputation with peers , were used as dependent variables . Primary analyses indicate that the PA intervention was more effective than the SC intervention at reducing inattention and moodiness in the home context . Less conservative follow-up analyses within ADHD status and intervention groups suggest that a PA intervention may reduce impairment associated with ADHD-risk in both home and school domains ; interpretive caution is warranted , however , given the liberal approach to these analyses . Unexpectedly , these findings also indicate the potential utility of a before school SC intervention as a tool for managing ADHD symptoms . Inclusion of a no treatment control group in future studies will enable further underst and ing of PA as an alternative management strategy for ADHD symptoms BACKGROUND Oppositional defiant disorder (ODD)is associated with a high degree of impairment in social skills , family interaction , and academic functioning . Comorbid ODD is reportedly present in 40 % to 70 % of children and adolescents with attention-deficit/hyperactivity disorder ( ADHD ) . OBJECTIVE The goal of this study was to assess the efficacy and safety of mixed amphetamine salts extended release ( MAS XR ) for the treatment of ODD in children and adolescents aged 6 to 17 years . METHODS This was a 4-week , multicenter , r and omized , double-blind , parallel-group , placebo-controlled , forced-dose-escalation study . Patients were r and omized to receive active treatment with MAS XR 10 , 20 , 30 , or 40 mg/d or placebo . The primary efficacy end point was the ODD subscale of the Swanson , Nolan , and Pelham-IV ( SNAP-IV ) parent rating . Primary safety measures included adverse events recorded at each visit and for 30 days after study drug discontinuation , and changes in vital signs , 12-lead electrocardiographic ( ECG ) findings , laboratory tests and physical examinations , and body weight . A post hoc efficacy re analysis was completed based on the results for the per- protocol population . For this analysis , patients were divided into high and low baseline severity categories according to the dichotomized baseline ODD parent or teacher score or dichotomized baseline ADHD parent or teacher score ( high defined as scores at the median or greater and low defined as scores less than the median ) . RESULTS A total of 308 children and adolescents ( age range , 6 - 17 years ; 213 males , 95 females ) were r and omized to receive active treatment with MAS XR 10 mg/d ( n = 60 ) 20 mg/d ( n = 58 ) , 30 mg/d ( n = 69 ) , or 40 mg/d ( n = 61 ) or placebo ( n = 60 ) . Of the 308 study patients , 244 ( 79.2 % ) had comorbid ADHD . A significant change from baseline in the ODD symptoms measured with the SNAP-IV parent rating subscale was found for the MAS XR 30-mg/d ( -0.52 ; P < 0.001 ) and 40-mg/d ( -0.56 ; P = 0.002 ) groups in the per- protocol analysis and for the MAS XR 30-mg/d group in the intent-to-treat analysis ( -0.42 ; P < 0.005 ) . Throughout the study , MAS XR was well tolerated in these children and adolescents with ODD , and most adverse events were mild to moderate in intensity . The most frequently reported adverse events occurring in MAS XR-treated patients were anorexia/decreased appetite ( 25.3 % ) , insomnia ( 19.5 % ) , headache ( 18.5 % ) , and abdominal pain ( 10.7 % ) . Statistically , but not clinical ly , significant decreases in body weight were seen with MAS XR ( range , -1.1 to -3.5 lb ; P < 0.001 vs placebo ) . Changes in laboratory values , ECG measurements , and physical and other vital signs were also not clinical ly significant . The post hoc re analysis was based on the per- protocol population ( n = 229 ) . An assessment of the high baseline symptom severity subgroups showed a good response to MAS XR treatment for the SNAP-IV parent and teacher rating scales ( both , P < 0.05 ) . CONCLUSION This study found that higher doses ofMAS XR ( 30 and 40 mg ) were effective and well tolerated in the management of ODD in these school aged children and adolescents in the presence or absence of ADHD
There is very-low- quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD , with and without ODD or CD .
There is moderate- quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD , with and without ODD .
There is high- quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD , with and without ODD or CD .
Conclusions : Evidence indicates that psychostimulants , alpha-2 agonists , and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms ; however , psychostimulants generally provide the most benefit
Objective : Children with attention-deficit hyperactivity disorder ( ADHD ) may have oppositional behaviour , conduct problems , and aggression .
These symptoms vary in severity , and may be related to a comorbid diagnosis of oppositional defiant disorder ( ODD ) or conduct disorder ( CD ) .
Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms .