# Prevalence, comorbidity, and demographic patterns of oppositional defiant disorder and conduct disorder in Chinese children and adolescents: a systematic review

## TL;DR

This paper reviews how common and what factors are linked to disruptive behavior disorders in Chinese children and adolescents.

## Contribution

The study provides a systematic review of ODD and CD prevalence, comorbidity, and demographic patterns in Chinese youth.

## Key findings

- Prevalence rates of ODD and CD in Chinese youth were mostly lower than global rates.
- Boys showed higher rates of disruptive behaviors compared to girls, and urban-rural differences influenced diagnosis rates.
- Parenting practices, peer rejection, and family conflict were linked to persistent symptoms.

## Abstract

The prevalence of major disruptive behavior disorders such as oppositional defiant disorder (ODD) and conduct disorder (CD) has not been fully described in Chinese youth, and their respective patterns are also understudied. This systematic review was conducted to explore prevalence rates, comorbidity, and demographic characteristics of ODD and CD in Chinese children and adolescents.

A thorough search of international databases revealed 19 peer-reviewed studies published in English between 2016 and 2025 that were pertinent and met the eligibility standards. The findings indicate that the prevalence rates of ODD and CD in Chinese youth were mostly lower than global rates; however, there was comorbidity with attention-deficit/hyperactivity disorder and depressive symptoms.

In several studies, it was noted that boys had higher rates of disruptive behaviors compared to girls, and urban–rural differences influenced diagnosis rates. Parenting practices, peer rejection, and family conflict were identified as predictors of symptom persistence through longitudinal studies, while deficiencies in executive functioning and emotional regulation were noted in neurocognitive research as significant interpersonal pathways. The use of advanced analytic methods, such as structural equation modeling and cross-lagged designs, strengthened causal inferences; however, comparability was restricted by methodological heterogeneity.

The prevalence of cross-sectional studies and reliance on parent/teacher reports limited conclusions. Future studies are encouraged to utilize culturally adapted diagnostic measures, longitudinal designs, and interventional approaches. The results highlight the importance of culturally responsive prevention and treatment interventions focused on the Chinese educational and family contexts.