Severe Conduct Disorder—Some Key Issues

OBJECTIVE: To examine the state of knowledge about clinically severe conduct disorder and identify key issues. METHOD: This paper surveys the literature on conduct disorder and delineates and discusses the critical issues. RESULTS: Conduct disorder is the subject of a vast and growing amount of research on taxonomy, correlates, etiology, outcome, management, and prevention. There are 2 distinctive types: childhood and adolescent onset. Comorbidity with other disorders is common. It remains a costly disorder, however, with a generally poor prognosis for the childhood-onset type. The validity of the separation of conduct and antisocial personality disorder is questionable. CONCLUSIONS: In view of its huge cost, chronicity, and generally poor outcome, childhood-onset or severe conduct disorder should be considered one of if not the major public health problems of our time, and resources for its study and management should reflect this. The disorder is poorly defined and inadequately studied in females.