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American Family Physician Nov 2018Conduct disorder is a psychiatric syndrome that most commonly occurs in childhood and adolescence. It is characterized by symptoms of aggression toward people or... (Review)
Review
Conduct disorder is a psychiatric syndrome that most commonly occurs in childhood and adolescence. It is characterized by symptoms of aggression toward people or animals, destruction of property, deceitfulness or theft, and serious violations of rules. Risk factors include male sex, maternal smoking during pregnancy, poverty in childhood, exposure to physical or sexual abuse or domestic violence, and parental substance use disorders or criminal behavior. At least three symptoms should have been present in the past 12 months, with at least one present in the past six months to diagnose conduct disorder. Interventions consist of treating comorbid conditions such as attention-deficit/hyperactivity disorder; supporting clear, direct, and positive communication within the family; and encouraging the family and youth to connect with community resources. There are several evidence-based psychosocial interventions that a psychologist or therapist may implement as part of long-term treatment. Currently, no medications have been approved by the U.S. Food and Drug Administration to treat conduct disorder. Treatment with psychostimulants is highly recommended for patients who have both attention-deficit/hyperactivity disorder and conduct problems. There is some evidence to support the treatment of conduct disorder and aggression with risperidone, but health care professionals should weigh the medication's potential benefits against its adverse metabolic effects.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Child; Conduct Disorder; Diagnosis, Differential; Female; Humans; Male; Parents; Primary Health Care; Risk Factors
PubMed: 30365289
DOI: No ID Found -
The Journal of Pediatrics Mar 2019To use the latest data to estimate the prevalence and correlates of currently diagnosed depression, anxiety problems, and behavioral or conduct problems among children,...
OBJECTIVES
To use the latest data to estimate the prevalence and correlates of currently diagnosed depression, anxiety problems, and behavioral or conduct problems among children, and the receipt of related mental health treatment.
STUDY DESIGN
We analyzed data from the 2016 National Survey of Children's Health (NSCH) to report nationally representative prevalence estimates of each condition among children aged 3-17 years and receipt of treatment by a mental health professional. Parents/caregivers reported whether their children had ever been diagnosed with each of the 3 conditions and whether they currently have the condition. Bivariate analyses were used to examine the prevalence of conditions and treatment according to sociodemographic and health-related characteristics. The independent associations of these characteristics with both the current disorder and utilization of treatment were assessed using multivariable logistic regression.
RESULTS
Among children aged 3-17 years, 7.1% had current anxiety problems, 7.4% had a current behavioral/conduct problem, and 3.2% had current depression. The prevalence of each disorder was higher with older age and poorer child health or parent/caregiver mental/emotional health; condition-specific variations were observed in the association between other characteristics and the likelihood of disorder. Nearly 80% of those with depression received treatment in the previous year, compared with 59.3% of those with anxiety problems and 53.5% of those with behavioral/conduct problems. Model-adjusted effects indicated that condition severity and presence of a comorbid mental disorder were associated with treatment receipt.
CONCLUSIONS
The latest nationally representative data from the NSCH show that depression, anxiety, and behavioral/conduct problems are prevalent among US children and adolescents. Treatment gaps remain, particularly for anxiety and behavioral/conduct problems.
Topics: Adolescent; Anxiety Disorders; Child; Child, Preschool; Conduct Disorder; Depressive Disorder; Female; Humans; Male; Prevalence; Socioeconomic Factors; Surveys and Questionnaires; United States
PubMed: 30322701
DOI: 10.1016/j.jpeds.2018.09.021 -
Italian Journal of Pediatrics Sep 2017Conduct Disorder (CD) is a psychiatric diagnosis characterized by a repetitive and persistent pattern of behaviour in which the basic rights of others and major... (Review)
Review
Conduct Disorder (CD) is a psychiatric diagnosis characterized by a repetitive and persistent pattern of behaviour in which the basic rights of others and major age-appropriate social norms or rules are violated. Callous Unemotional (CU) traits are a meaningful specifier in subtyping CD for more severe antisocial and aggressive behaviours in adult psychopathology; they represent the affective dimension of adult psychopathy, but they can be also detected in childhood and adolescence. The CU traits include lack of empathy, sense of guilt and shallow emotion, and their characterization in youth can improve our diagnostic, prognostic and therapeutic abilities. A strong genetic liability, in interaction with parenting and relevant environmental factors, can lead to elevated levels of CU traits in children. We pointed out that CU traits can be detected in early childhood, may remain stable along the adolescence, but a decrease following intensive and specialized treatment is possible. We here provide a narrative review of the available evidences on CU traits in three main domains: aetiology (encompassing genetic liability and environmental risk factors), presentation (early signs and longitudinal trajectories) and treatments.
Topics: Adolescent; Antisocial Personality Disorder; Child; Conduct Disorder; Emotions; Empathy; Female; Humans; Male; Narration; Parent-Child Relations; Parenting; Prognosis; Risk Assessment; Severity of Illness Index
PubMed: 28931400
DOI: 10.1186/s13052-017-0404-6 -
The New England Journal of Medicine Dec 2014The term “conduct problems” refers to a pattern of repetitive rule-breaking behavior, aggression, and disregard for others. Such problems have received increased... (Review)
Review
The term “conduct problems” refers to a pattern of repetitive rule-breaking behavior, aggression, and disregard for others. Such problems have received increased attention recently, owing to violent events perpetrated by youth and modifications in the (DSM) criteria for conduct disorder, a syndrome involving recurrent conduct problems in children and adolescents. Youth conduct problems are predictive of an increased risk of substance abuse, criminal behavior, and educational disruption; they also incur a considerable societal burden from interpersonal suffering and financial costs. This review summarizes current data on youth conduct problems and highlights promising avenues for research. Prior reviews have summarized either the clinical literature on outcome, treatment, and familial aggregation or the neurocognitive literature on mechanisms and pathophysiology. The current review differs by more tightly integrating clinical and neurocognitive perspectives.
Topics: Adolescent; Amygdala; Antisocial Personality Disorder; Child; Child Behavior Disorders; Cognition Disorders; Conduct Disorder; Decision Making; Empathy; Humans; Magnetic Resonance Imaging; Psychotherapy; Social Environment
PubMed: 25470696
DOI: 10.1056/NEJMra1315612 -
Psychiatry Research Oct 2022This study evaluates the clinical validity of a five-minute instrument, the Conduct and Oppositional Defiant Disorder Scales (CODDS), for assessing oppositional defiant...
This study evaluates the clinical validity of a five-minute instrument, the Conduct and Oppositional Defiant Disorder Scales (CODDS), for assessing oppositional defiant disorder (ODD) and conduct disorder (CD). Children (N = 428) aged 11-12 years and their caregiver were administered the NIMH DISC-IV (Diagnostic Interview Schedule for Children), the CODDS, and validity measures. A second sample (N = 671) was utilized to develop a brief measure of limited prosocial emotions based on DSM 5. Receiver operating characteristic (ROC) curves documented good sensitivity and specificity for CODDS scales in predicting DISC-IV clinical diagnoses of ODD (85%, 72% respectively) and CD (85%, 88%) diagnoses. Baseline CODDS provided added value over and above baseline clinical DISC- diagnoses in predicting future DISC ODD and CD diagnoses 12 months later, as well as in predicting social and school functioning. Study 2 further established psychometric properties of the CODDS, with brief measures of CODDS limited prosocial emotions (LPE) having a good fit to the hypothesized DSM 5 four-factor structure of LPE. Findings indicates that the CODDS has utility as a five-minute proxy for diagnoses of ODD and CD in clinical research and potentially practice where time and resources are limited.
Topics: Attention Deficit and Disruptive Behavior Disorders; Child; Conduct Disorder; Diagnostic and Statistical Manual of Mental Disorders; Emotions; Humans; Psychometrics
PubMed: 35961152
DOI: 10.1016/j.psychres.2022.114744 -
Journal of Traumatic Stress Apr 2021We tested within- and between-person effects of posttraumatic stress disorder (PTSD) symptoms on conduct problems and alcohol intoxication via self-control demands using...
We tested within- and between-person effects of posttraumatic stress disorder (PTSD) symptoms on conduct problems and alcohol intoxication via self-control demands using multilevel structural equation modeling in a longitudinal burst-design study of 251 U.S. veterans who participated in the recent wars in Iraq and Afghanistan. We theorized that experiencing PTSD symptoms engenders efforts to regulate mood, control thoughts, and inhibit or control behavior that is taxing to the individual (i.e., it places demands on self-control) and hypothesized that this process results in subsequent deficits in regulatory control that manifest in heightened intoxication and conduct problems associated with PTSD. At the within-person level, daytime PTSD symptoms, IRR = 1.09, and self-control demands, IRR = 1.12, exhibited within-person associations with nighttime conduct problems over and above nighttime intoxication. Consistent with our hypothesis, daytime increases in self-control demands mediated the associations between daytime PTSD symptoms and subsequent nighttime conduct problems. The indirect effect between daytime PTSD symptoms and nighttime intoxication via self-control demands was nonsignificant. At the between-person level, self-control demands mediated the associations between PTSD symptoms and conduct problems; however, the expected between-person associations with intoxication were nonsignificant. Drinking behavior is related to but cannot fully account for various difficulties in psychosocial functioning associated with PTSD. The present results suggest that dysregulated behavior may, ironically, stem from individuals' concerted efforts to control and manage overwhelming symptoms. Self-control demands may be a common factor that accounts for a broad range of functional impairments associated with PTSD.
Topics: Adult; Afghan Campaign 2001-; Alcoholic Intoxication; Conduct Disorder; Female; Humans; Interpersonal Relations; Iraq War, 2003-2011; Longitudinal Studies; Male; Self-Control; Stress Disorders, Post-Traumatic; United States; Veterans
PubMed: 33128809
DOI: 10.1002/jts.22601 -
International Journal of Environmental... Oct 2021Conduct disorder is a psychiatric diagnosis characterized by repetitive and persistent norm-breaking behavior. This study aimed to compare the risk of conduct disorder...
INTRODUCTION
Conduct disorder is a psychiatric diagnosis characterized by repetitive and persistent norm-breaking behavior. This study aimed to compare the risk of conduct disorder between first- and second-generation immigrant children and adolescents and their native controls.
METHODS
In this nationwide, open-cohort study from Sweden, participants were born 1987-2010, aged 4-16 years at baseline, and were living in the country for at least one year during the follow-up period between 2001 and 2015. The sample included 1,902,526 and 805,450 children-adolescents with native and immigrant backgrounds, respectively. Data on the conduct disorder diagnoses were retrieved through the National Patient Register. We estimated the incidence of conduct disorder and calculated adjusted Hazard Ratios.
RESULTS
Overall, the adjusted risk of conduct disorder was lower among first-generation immigrants and most second-generation immigrant groups compared with natives (both males and females). However, second-generation immigrants with a Swedish-born mother and a foreign-born father had a higher risk of conduct disorder than natives. Similar results were found for sub-diagnoses of conduct disorder.
CONCLUSIONS
The higher risk of conduct disorder among second-generation immigrants with a Swedish-born mother and the lower risk among most of the other immigrant groups warrants special attention and an investigation of potential underlying mechanisms.
Topics: Adolescent; Child; Cohort Studies; Conduct Disorder; Emigrants and Immigrants; Female; Humans; Incidence; Male; Sweden
PubMed: 34682389
DOI: 10.3390/ijerph182010643 -
Addiction (Abingdon, England) Oct 2022Several studies have indicated an association between maternal prenatal substance use and offspring externalizing disorders; however, it is uncertain whether this... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
Several studies have indicated an association between maternal prenatal substance use and offspring externalizing disorders; however, it is uncertain whether this relationship is causal. We conducted a systematic review to determine: (1) if the literature supports a causal role of maternal prenatal substance use on offspring externalizing disorders diagnosis and (2) whether these associations differ across externalizing disorders.
METHODS
We searched Web of Science, Embase, PsycINFO and Medline databases. Risk of bias assessment was conducted using the Newcastle-Ottawa Scale (NOS), and where possible meta-analysis was conducted for studies classed as low risk of bias. We included studies of any design that examined prenatal smoking, alcohol or caffeine use. Studies in non-English language, fetal alcohol syndrome and comorbid autism spectrum disorders were excluded. Participants in the included studies were mothers and their offspring. Measurements included prenatal smoking, alcohol or caffeine use as an exposure, and diagnosis of attention-deficit hyperactivity disorder (ADHD), conduct disorder (CD) and oppositional defiant disorder (ODD) in offspring as an outcome.
RESULTS
We included 63 studies, 46 of which investigated smoking and ADHD. All studies were narratively synthesized, and seven studies on smoking and ADHD were meta-analysed. The largest meta-analysis based on genetically sensitive design included 1 011 546 participants and did not find evidence for an association [odds ratio (OR) = 0.90, 95% confidence interval (CI) = 0.83-1.11; OR = 1.04, 95% CI = 0.79-1.36). Studies on alcohol exposure in all the outcomes reported inconsistent findings and no strong conclusions on causality can be made. Studies on caffeine exposure were mainly limited to ADHD and these studies do not support a causal effect.
CONCLUSIONS
There appears to be no clear evidence to support a causal relationship between maternal prenatal smoking and offspring attention-deficit hyperactivity disorder. Findings with alcohol and caffeine exposures and conduct disorder and oppositional-defiant disorder need more research, using more genetically sensitive designs.
Topics: Attention Deficit Disorder with Hyperactivity; Caffeine; Conduct Disorder; Ethanol; Female; Humans; Pregnancy; Prenatal Exposure Delayed Effects; Smoking; Substance-Related Disorders
PubMed: 35385887
DOI: 10.1111/add.15858 -
BMC Psychiatry Dec 2020Conduct disorder (CD), a serious behavioral and emotional disorder in childhood and adolescence, characterized by disruptive behavior and breaking societal rules....
BACKGROUND
Conduct disorder (CD), a serious behavioral and emotional disorder in childhood and adolescence, characterized by disruptive behavior and breaking societal rules. Studies have explored the overlap of CD with neurodevelopmental problems (NDP). The somatic health of children with NDP has been investigated; however, the prevalence of these problems in children with CD has not been sufficiently studied. Holistic assessment of children with CD is required for establishing effective treatment strategies.
AIMS
(1) Define the prevalence of selected neurological problems (migraine and epilepsy) and gastrointestinal problems (celiac disease, lactose intolerance, diarrhea, and constipation) in a population of twins aged 9 or 12; (2) Compare the prevalence of somatic problems in three subpopulations: (a) children without CD or NDP, (b) children with CD, and (c) children with both CD and NDP; (3) Select twin pairs where at least one child screened positive for CD but not NDP (proband) and map both children's neurological and gastrointestinal problems.
METHOD
Telephone interviews with parents of 20,302 twins in a cross-sectional, nationwide, ongoing study. According to their scores on the Autism-Tics, AD/HD, and Comorbidities inventory, screen-positive children were selected and divided into two groups: (1) children with CD Only, (2) children with CD and at least one NDP.
RESULTS
Children with CD had an increased prevalence of each neurological and gastrointestinal problem (except celiac disease), and the prevalence of somatic problems was further increased among children with comorbid CD and NDP. The presence of CD (without NDP) increased the odds of constipation for girls and the odds of epilepsy for boys. Girls with CD generally had more coexisting gastrointestinal problems than boys with CD. Female co-twins of probands with CD were strongly affected by gastrointestinal problems. Concordance analyses suggested genetic background factors in neurological and gastrointestinal problems, but no common etiology with CD could be concluded.
CONCLUSION
Co-occurring NDP could explain most of the increased prevalence of somatic problems in CD. Our results raise a new perspective on CD in children and adolescents; their CD seems to be linked to a number of other health problems, ranging from neurodevelopmental and psychiatric disorders to somatic complaints.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Child; Conduct Disorder; Cross-Sectional Studies; Female; Humans; Male; Problem Behavior; Tic Disorders; Twins
PubMed: 33334305
DOI: 10.1186/s12888-020-03003-2 -
Journal of Affective Disorders Feb 2023The co-occurrence between major depression disorder (MDD) and conduct disorder (CD) is common across development and represents a significant risk factor for future... (Review)
Review
INTRODUCTION
The co-occurrence between major depression disorder (MDD) and conduct disorder (CD) is common across development and represents a significant risk factor for future psychiatric problems and long-term impairment. Large-scale quantitative genetic studies suggest that the MDD-CD co-occurrence may be partly explained by shared genetic vulnerability factors, in line with transdiagnostic models of psychopathology, but no systematic synthesis of the literature is currently available.
METHODS
We therefore conducted a systematic review of the available genetic literature on the co-occurrence between MDD and CD in children and adolescents. We identified 10 eligible studies, including 5 cross-sectional bivariate/multivariate twin studies, 3 longitudinal bivariate/multivariate twin studies, and 2 latent profile/trajectory twin studies.
RESULTS
Most of the reviewed studies found a strong contribution of shared genetic factors on the covariation between depression and conduct problems, in line with the prominent effect of a common genetic liability across development.
LIMITATIONS
The scientific literature on this psychiatric comorbidity is still limited, as it solely consists of twin studies from high income countries.
CONCLUSION
Considering the joint burden of MDD and CD on youth, families and society worldwide, future studies are needed to better investigate the shared risk processes of these frequently co-occurring conditions, in order to inform new treatments through personalized medicine.
Topics: Child; Adolescent; Humans; Conduct Disorder; Depression; Cross-Sectional Studies; Diseases in Twins; Comorbidity; Depressive Disorder, Major
PubMed: 36356897
DOI: 10.1016/j.jad.2022.11.001