Read this topic

Conduct disorder matters because it identifies a repetitive pattern of behaviour that genuinely violates other people's basic rights or societal norms, and because its age of onset predicts how the illness tends to progress. It is diagnosed as a repetitive, persistent pattern of behaviour violating the basic rights of others or major age-appropriate societal norms, including aggression, destruction of property, deceitfulness or theft, and serious rule violations. For example, imagine a fourteen-year-old who has repeatedly bullied and physically hurt other children, deliberately started fires, and been caught shoplifting on multiple occasions. In practice, that combination of harm to others and serious rule-breaking is what places this behaviour firmly within conduct disorder.

Two onset specifiers exist, childhood-onset, with at least one symptom before age ten, and adolescent-onset, with no symptoms before age ten, and childhood-onset conduct disorder carries a worse prognosis and a stronger link to adult antisocial personality disorder. Symptom categories are aggression to people or animals, destruction of property, deceitfulness or theft, and serious violations of rules, such as running away from home or truancy. Take two boys with conduct disorder: one showed cruelty to animals from age seven (childhood-onset, higher risk), the other began stealing and fighting only after starting secondary school at age twelve (adolescent-onset, generally better prognosis). In practice, establishing the age of first symptom onset therefore has real prognostic value, not just diagnostic value.

• A boy with conduct disorder shows no remorse, is unconcerned about poor performance, and has shallow affect. Which specifier applies?
• When may an antipsychotic be considered for a child with conduct disorder?
• How does the sex distribution of conduct disorder in childhood compare between boys and girls?

• Oppositional defiant disorder, defiance and vindictiveness without serious rights violation, unlike conduct disorder's aggression, destruction, deceit, or theft.
• Antisocial personality disorder, cannot be diagnosed before age eighteen, unlike conduct disorder, which is diagnosed in childhood or adolescence and typically precedes it.
• Adolescent-onset conduct disorder, symptoms beginning after age ten, generally with a better prognosis than childhood-onset conduct disorder.
• Conduct disorder, repetitive and persistent pattern of rights-violating behaviour, unlike an isolated incident of misbehaviour, which does not meet the diagnostic threshold.

• Medication does not treat the core conduct symptoms.
• Antidepressants are not a prerequisite step in this pathway.
• This is a presentation of attention deficit hyperactivity disorder.
• InsightA person's awareness and understanding that they are unwell and need help.Read more → specifiers apply to obsessive-compulsive and related disorders.
• CatatoniaA syndrome of abnormal movement and behaviour, ranging from being frozen and unresponsive to being excessively agitated.Read more → is a separate syndrome unrelated to this specifier.

• Extract the defining phenomenology, duration, severity and functional-impact clues.
• Match the pattern to the most specific diagnostic or assessment construct.
• Actively test the closest look-alike against the missing or contradictory clue.
• Choose the precise term rather than a broader category that is merely compatible.