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Conduct disorders

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Abstract

Conduct disorder (CD) is a frequently occurring psychiatric disorder characterized by a persistent pattern of aggressive and non-aggressive rule breaking antisocial behaviours that lead to considerable burden for the patients themselves, their family and society. This review paper updates diagnostic and therapeutic approaches to CD in the light of the forthcoming DSM-5 definition. The diagnostic criteria for CD will remain unchanged in DSM-5, but the introduction of a specifier of CD with a callous-unemotional (CU) presentation is new. Linked to this, we discuss the pros and cons of various other ways to subtype aggression/CD symptoms. Existing guidelines for CD are, with few exceptions, already of a relatively older date and emphasize that clinical assessment should be systematic and comprehensive and based on a multi-informant approach. Non-medical psychosocial interventions are recommended as the first option for the treatment of CD. There is a role for medication in the treatment of comorbid syndromes and/or in case of insufficient response to psychosocial interventions and severe and dangerous aggressive and violent behaviours.

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Conflict of interest

Jan K Buitelaar has in the past 3 years been a consultant to/member of the advisory board of and/or a speaker for Janssen Cilag BV, Eli Lilly, Bristol-Myer Squibb, Shering Plough, UCB, Shire, and Novartis and Servier. He is not an employee of any of these companies and is not a stock shareholder of any of these companies. He has no other financial or material support, including expert testimony, patents and royalties. This article is part of the supplement “The Future of Child and Adolescent Psychiatry and Psychology: The Impact of DSM 5 and of Guidelines for Assessment and Treatment”. This supplement was not sponsored by outside commercial interests.

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Authors and Affiliations

  1. Department of Cognitive Neuroscience, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, P.O. Box 9101, (204) 6500 HB, Nijmegen, The Netherlands

    Jan K. Buitelaar & Jeffrey Glennon

  2. Department of Psychiatry, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands

    Nanda N. J. Rommelse

  3. Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands

    Jan K. Buitelaar, Kirsten C. Smeets, Pierre Herpers & Nanda N. J. Rommelse

  4. Department of Psychiatry, UMC Utrecht, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands

    Floor Scheepers

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  1. Jan K. Buitelaar
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  6. Nanda N. J. Rommelse
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Correspondence to Jan K. Buitelaar.

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Buitelaar, J.K., Smeets, K.C., Herpers, P. et al. Conduct disorders. Eur Child Adolesc Psychiatry 22 (Suppl 1), 49–54 (2013). https://doi.org/10.1007/s00787-012-0361-y

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