Conduct Disorders

Conduct Disorders Persistent repetitive socially unacceptable behaviours which is not ordinary childhood mischief or adolescent rebelliousness

Conduct Disorders Why do we need to know about them ? Commonest psychiatric disorder in childhood and adolescence May persist into adult life

When do they present to a doctor ……? When it cannot be tolerated by the family due to the disorder due to parental factors

Conduct Disorders Preschool children Aggressive behaviour at home and towards other children Overactivity

Conduct Disorders Older children Disobedience Lying Aggressive behaviour Problems at school

Truanting Stealing Vandalism ( deliberately damaging property ) and Arson ( fire setting ) Disapproved sexual behaviour Alcohol and drug abuse

Other features Early sexual behaviour Gang involvement Low self esteem Lack of empathy

Aetiology Problems within the family Problems within the child Problems in the environment

Aetiology Family unstable, insecure families lack of affection rejection broken homes parental violence & aggression inconsistent and ineffective discipline

Environment deprived areas over - crowding high crime rates low socio-economic conditions and poverty

Child Lack of a warm parental relationship School Failure Speech and reading difficulties Social Isolation Brain damage Epilepsy Exposure to abuse and societal violence

prognosis Some may improve 2/3 rds may persist into adult life

Predictors of poor outcome Early onset ( before 10 yrs ) Low IQ Poor school achievement Attention problems and hyperactivity Family criminality Low socio economic status Poor parenting

Treatment look for stress factors and reduce them if possible Special schooling if needed Behavioural methods - reinforcement Support to the parents

Ensure safety of the child Medication for comorbid conditions eg ADHD