Conduct disorder - Information

Serious and persistent patterns of disturbed conduct and antisocial behaviour predominantly affect boys and comprise the largest group of childhood psychiatric disorders. Conduct disturbance may begin early in childhood, manifesting as oppositional, aggressive and defiant behaviour becoming established during the primary school years and amplifying after puberty. The presence of other psychological disorders is common in these children, with about 30% showing ADHD and learning problems. Clinical depression is also found in about 20% of young people with conduct disorder, and, although controversial, a prospective study suggests that this emotional disturbance is secondary to the conduct disorder.
The clinical features are shown in Box 5. This group of childhood disorders requires vigorous early intervention, assessment and management because, although about a third make a reasonable adjustment, there is evidence that at least half of the young people with serious conduct disorder will continue to experience mental health and psychosocial problems in adult life, such as personality disorder, criminality and alcoholism, and about 5% develop schizophrenia.

Depression - common behaviour

Common behaviour associated with depression includes:
a moodiness that is out of character
a increased irritability and frustration
a finding it hard to take minor personal criticisms
a spending less time with friends and family
a loss of interest in food, sex, exercise or other pleasurable activities
a being awake throughout the night
a increased alcohol and drug use
a staying home from work or school
a increased physical health complaints like fatigue or pain
a being reckless or taking unnecessary risks (e.g. driving fast or dangerously)
a slowing down of thoughts and actions.

Conduct disorder

Symptoms
Persistent disruptive and antisocial behaviour
Hostile, defiant, spiteful, vindictive behaviour
Aggression towards people and animals
Vandalism, fire lighting
Truancy, lying, stealing
Acting alone (about 20%)
Acting with group (about 80%)
Hyperactive (about 30%) and with learning problems (about 50%)
Depression, low self-esteem (about 20%)
Running away from home

Family factors
Social disadvantage
Large family size
Inconsistent, hostile parenting (father's role)
Parental conflict
Foster home/institutional care
Parental mental illness and criminality
Child abuse and family violence
Antisocial peer groups

Management
Early intervention: parenting-skills training
Creating opportunities for success in sport and recreation
Success achievement in educational programs
Behaviour treatment (social skills)
Family therapy for conflict and criticism