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Conduct Disorder What is conduct disorder?

What is conduct disorder?

Conduct disorder is a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. Conduct disorder refers to a clinical category characterized by the co-occurrence of several anti-social and aggressive behaviors over a given period of time (6 month in ICD-10, 12 month in DSM-IV diagnostic criteria).

Main clinical features of conduct disorder are:

  • aggression to people and animals,
  • destruction of property,
  • deceitfulness or theft,
  • serious violations of rules.

Clinical presentation is heterogenous: some children and adolescents show a predominance of overt antisocial behavior such as reactive aggression, theft with confrontation, use of weapons, etc., while some show more covert antisocial behaviors (truancy, lying, stealing without confrontation, etc.). Severity is variable as is social context but to retain a clinical diagnosis of conduct disorder impairment in social, academic or occupational functioning has to be significant.

A diagnosis of conduct disorder requires a careful developmental history and a thorough analysis of the temporal pattern of symptoms and environmental context. A significant proportion of children/adolescents with antisocial behaviors will not meet criteria for conduct disorder. Furthermore, mild and occasional conduct problems can be seen in normally developing children/adolescents and, in the general population, aggressive behavior tends to decrease across the first 10 years of life. Although conduct disorder heightens risk for delinquency, the first is a clinical category and the latter is a legal term referring to offenses against the law.

Conduct disorder is a serious public health concern because of its high psychiatric morbidity and association with risk-taking behaviors, legal complication and overall impairment of adaptive functioning.