Overview

• Conduct Disorder → repetetive and persistent pattern of antisocial behaviour for >6 months, affecting those <18yo.
• Risk Factors:
  • Child Factors → ADHD, low IQ, chronic illness.
  • Family Factors → poor parenting behaviours, parental criminality, FH of substance misuse, maternal depression.
  • Environmental Factors → urban upbringing, deprivation, low socioeconomic status.
• Oppositional Defiant Disorder:
  • Milder form of conduct disorder. Characterised by markedly defiant, disobedient, dirsuptive behaviour but does not include delinquent acts or more extreme forms of aggressive/dissocial behaviour.

Making Diagnosis

Clinical Features

• Repetitive and persistent (>6 months) patter of dissocial, aggresive or defiant conduct.
  • Examples → bullying, stealing, fighting, fire-setting, destruction, truancy.
  1. Aggression towards people and animals.
  2. Deceifulness or theft.
  3. Serious violation of rules.
  4. Destruction of property.
• Behaviour is persistently antisocial.

Investigations

• Reports from parents, teachers etc.
• Developmental assessment.
• Strengths and difficulties questionnaire (usually in CAMHS).
• Child behaviour checklist (usually in CAMHS).

Management Plan

• First Line → parent training programmes/family education.
• Second Line → child focussed programmes.
  • Anger management, social skills, problem solving.