PRACTICE PARAMETERS FOR THE ASSESSMENT AND TREATMENT OF CHILDREN AND ADOLESCENTS WITH CONDUCT DISORDER

These practice parameters address the diagnosis, treatment, and preven tion of conduct disorder in children and adolescents. Voluminous liter ature addresses the problem from a developmental, epidemiological, and criminological perspective. Properly designed treatment outcome studi es of modern psychiatric modalities are rare. Ethnic issues are mentio ned but not fully addressed from a clinical perspective. Clinical feat ures of youth with conduct disorder include predominance in males, low socioeconomic status, and familial aggregation. Important continuitie s to oppositional defiant disorder and antisocial personality disorder have been documented. Extensive comorbidity, especially with other ex ternalizing disorders, depression, and substance abuse, has been docum ented and has significance for prognosis. Clinically significant subty pes exist according to age of onset, overt or covert conduct problems, and levels of restraint exhibited under stress. To be effective, trea tment must be multimodal, address multiple foci, and continue over ext ensive periods of time. Early treatment and prevention seem to be more effective than later intervention.