Conduct Disorder and oppositional Defiant Disorder

Conduct disorder is defined as a repetitive and persistent pattern of behavior in which the basic rights of others or important age-appropriate societal norms or rules are violated. Disordered behaviors include aggression toward people or animals, destruction of property, deceitfulness, theft, or serious violations of rules (school truancy, running away).

Conduct disorder is the childhood equivalent of adult antisocial personality disorder (ASP). It is the most common disorder seen in outpatient psychiatric clinics and is rrequently seen comorbidly with AD HD or learning disorders. Adoption studies show a genetic predisposition, but psychosocial factors playa major role. Parental separation or divorce, parental substance abuse, severely poor or inconsistent parenting, and association with a delinquent peer group have been shown to have some relationship to the development of conduct disorder.
Treatment involves individual and family therapy.

Some children may need to be removed from the home and placed in foster care. Parents who retain custody of a child with conduct disorder are taught limit setting, consistency, and other behavioral techniques.

Medications are used only to treat a comorbid ADHD or mood disorder but not for the conduct disorder itself The long-term outcome depends on the severity of the disorder and the degree and type of comorbidity. Twenty-five percent to 40% of children with conduct disorder go on to have adult ASP.

Oppositional defiant disorder is diagnosed in children with annoying, difficult, or disruptive behavior when the frequency of the behavior significantly exceeds that of other children his or her mental age (or that is less tolerated in the child’s particular culture). It is a relatively new diagnosis that is meant to describe children with behavior problems that do not meet criteria for full-blown conduct disorder.
Management emphasizes individual and family counseling.

KEY POINTS
1. Conduct disorder is the childhood equivalent of ASP.
2. It is defined by observable measurable behaviors.
3. Conduct disorder is the most common diagnosis in outpatient child psychiatric clinics.
4. It is managed by limit setting, consistency, and behavioral techniques.
5. Oppositional defiant disorder is a less severe form of conduct disorder.

Provided by ArmMed Media
Revision date: June 11, 2011
Last revised: by Andrew G. Epstein, M.D.