Conduct Disorder

Methylphenidate Helps in DB: 6-15yos 83 pt. 31% conduct disorder alone, 69% conduct disorder plus ADHD. 74 completed trial 5 weeks. Considerbly better by parents, teachers, psychiatrists, and trained classroom observer on nearly all measures of conduct disorder. Less cruelty, less obscene language, less property destruction, less stealing. Mothers rates 78% globally improved vs 27% placebo. Similar differences for other groups. Improvement of aggressive behavior not associated with level of initial ADHD. Klein R, et al: Clinical efficacy of methylphenidate in conduct disorder with and without attention deficit hyperactivity disorder. Arch Gen Psyc 97;54:1073-80. NIMH funded Long Island Jewish.

Conduct Disorder Predicts Anti-Social Personality Disorder: 90% of APD cases met criteria for CD at least once during ages 13-17, and very few youths who met criteria for ODD during this period progressed to APD without intermediate CD. While CD is a strong predictor of modified APD, when other factors were accounted for in regression analyses, the best predictors were callous/unemotional behaviour, depression and marijuana use. ADHD during ages 13-17 was not significant in the final model. U Pitt. What are adolescent antecedents to antisocial personality disorder? Loeber R, Burke JD, Lahey BB. Crim Behav Ment Health 2002;12(1):24-36

Poverty a Cause: A study looked at the effect of the opening of an Indian casino on the rates of psychiatric disorders in Indian children.  Some families suddenly received higher regular income thanks to payments from the casino because it belonged to their tribe.  Their rates of conduct and oppositional defiant disorders decreased considerably while other Indian children whose family income remained low remained at higher rates.  Anxiety and depressive disorders were unaffected. Relationships between poverty and psychopathology: a natural experiment. Costello EJ, Compton SN, Keeler G, Angold A. JAMA. 2003 Oct 15;290(15):2023-9

Thomas E. Radecki, M.D., J.D.

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