The incidence of so-called CONDUCT DISORDER is rising significantly, appearing in both CHILDHOOD-onset (before age ten) and ADOLESCENT-onset (after age ten) forms.
Both forms are characterized by a failure to comply with rules, norms, and laws imposed by authority figures, as well as the constant violation of the rights of others. The condition is not linked to known organic abnormalities and is often considered secondary to Oppositional Defiant Disorder and/or Attention-Deficit/Hyperactivity Disorder. It is more prevalent in males and carries a poor prognosis, often involving ongoing problems and a failure to return to normal functioning.
It is characterized by aggression and the frequent infliction of physical injury on others, as well as substance abuse. Family history and head trauma involving the temporal lobe are common factors; intelligence is usually below average; and aggression increases in both frequency and intensity when psychotic symptoms are present.
In the preadolescent or adolescent form, the condition is more common in girls, and the prognosis tends to be more favorable. Behavioral violence is absent or minimal; the disorder is often associated with depression and anxiety, potentially leading to suicidal thoughts or actual suicide attempts. Intelligence levels are normal, and patients typically express remorse for their misconduct and are amenable to reason, although they often relapse into old patterns. Appropriate treatment is generally effective.
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