Conduct disorder is a repeated pattern of behavior in children or teens that breaks the rights of others or major social rules, such as aggression, destruction, theft or running away. Early family-based treatment matters, because without it some young people go on to antisocial personality disorder in adulthood.
Key symptoms
- Bullying, fighting or cruelty to people or animals
- Destroying property or setting fires
- Lying, stealing or breaking into homes or cars
- Running away, truancy, staying out at night
- Little guilt or empathy in some patients
What you find on exam
- Interview the teen alone and with the family
- Mental status exam, including mood and suicidal thoughts
- Look for injuries and signs of abuse at home
- Screen for ADHD, learning disorders, depression and substance use
Tests
- Diagnosis is clinical, using DSM-5 criteria
- Rating scales from parents and teachers
- Urine drug screen if substance use is suspected
- Educational testing for learning problems
Treatment basics
- Parent management training and family therapy
- Multisystemic therapy involving home, school and community
- Cognitive behavioral therapy focused on problem solving and anger control
- Treat ADHD, depression or substance use if present
- Medicine only for severe aggression, as part of a full plan
Red flags
- Threats or plans to harm others, or access to weapons
- Suicidal thoughts or self-harm
- Signs of abuse or an unsafe home
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Related guides
Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.