Academic journal article Indian Journal of Psychiatry

Prevalence of Conduct Disorder in Schoolchildren of Kanke

Academic journal article Indian Journal of Psychiatry

Prevalence of Conduct Disorder in Schoolchildren of Kanke

Article excerpt

Byline: Sujit. Sarkhel, Vinod. Sinha, Manu. Arora, Pushpal. DeSarkar

Background: Prevalence estimates of conduct disorder, one of the most frequently diagnosed psychiatric conditions in children, vary widely from 0.2% to 8.7%. Aim: To find out the prevalence of conduct disorder and its DSM-IV subtypes and comorbid attention deficit hyperactivity disorder (ADHD) in 4 schools of Kanke block among students of classes V to X. Methods: A total of 240 students, selected by stratified random sampling, were subjected to the Schedule for Affective Disorders and Schizophrenia for School Age Children: Present and Lifetime Version (K-SADS-PL) screening interview. Nineteen students who qualified were subjected to conduct disorder and ADHD supplement of K-SADS-PL with additional information from parents. Results: Conduct disorder was found in 4.58%; the ratio of boys to girls being 4.5:1. Childhood onset was found in 73% and adolescent onset in 27%. Mild conduct disorder was found in 36%, moderate in 64% and severe conduct disorder in none. Comorbid ADHD was found in 36%, hyperactive-impulsive being predominant. Significant difference was found in temperament between students with and without conduct disorder with difficult temperament predominating in the former and easy in the latter (p=0.004). Lying, bullying and cruelty to animals were most frequent symptoms. Conclusion: The prevalence of conduct disorder was 4.58%, more common in boys, the majority had childhood onset, and one-third had comorbid ADHD.

Introduction

The term conduct disorder (CD) refers to a persistent pattern of antisocial behaviour in which the individual repeatedly breaks social rules and carries out aggressive acts that upset other people. DSM-IV mentions CD as one of the most frequently diagnosed conditions in outpatient and inpatient mental health facilities for children.[1] CD has been separated from the adult diagnosis of antisocial personality in order to acknowledge what psychiatrists believe to be a greater potential for change in the young. CD has been classified along with oppositional defiant disorder and attention-deficit hyperactivity disorder (ADHD) in the attention-deficit and disruptive behaviour disorders section of DSM-IV-TR.[2]

The essential feature of CD is a repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated. Since its inception in DSM-III, the diagnosis of CD has undergone several modifications. DSM-IV-TR lists 15 criteria grouped into 4 major categories: (i) aggression to people and animals; (ii) destruction of property; (iii) deceitfulness or theft; and (iv) serious violations of rules. Three (or more) of the criteria should have been present for the last 12 months, with at least one criterion present in the past 6 months. The disturbance in behaviour should cause clinically significant impairment in social, academic, or occupational functioning. If the individual is 18 years or older, the criteria for antisocial personality disorder should not be met.[2]

Since the criteria for the diagnosis of CD vary widely, its manifestations at different developmental stages differ and because the databases of different studies are not uniform, the prevalence estimates reported in various studies vary widely.[3] At one end lies the study of Esser and colleagues[4] reporting a prevalence of 0.9%, while at the other end is the study by Kashani et al. [5] reporting a prevalence of 8.7%. DSM-IV reports a prevalence in males of 6%-10% and in females of 2%-9%.[1] The ratio of males to females with CD is lower for the adolescent-onset type than for the childhood-onset type.[2] Among Indian studies, Deivasigamani[6] has reported the prevalence of CD to be 11.13%, Sarkar et al. [7] reported the prevalence rate of antisocial behaviour to be 7.1% while recently Srinath et al.[8] have reported a prevalence as low as 0.2%. …

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