Determinants of poor outcome of conduct disorder among children and adolescents: A 1-year follow-up study

Abstract

Background: Conduct disorder (CD) is a heterogeneous disorder with variations in symptomatology and outcome. Slightly more than half of CD ceases to meet the criteria for CD during late childhood or adolescence. Many studies had examined the factors that determine the outcome of CD. However, limited follow-up studies are available in the Indian context. The present study aims to identify the factors that determine the poor outcome of CD. Materials and Methods: This was a clinic-based follow-up study. The study population consists of 300 consecutive children between 6 and 18 years of age who satisfied the International Classification of Disease-10 Diagnostic Criteria for Research guidelines for CD. Study setting was behavioral pediatrics unit under tertiary care pediatric department. Recruited children were intervened and followed up for 1 year. Initial and final scores of abnormal psychosocial situation, symptom severity, and functional level were assessed. A percentage of children who achieved clinically significant improvement were noticed. Determinants of poor outcome were identified by logistic regression. Results: Clinically significant improvement was observed among 64.51% of sample. Determinants of poor outcome were family history of single parent, alcoholism, domestic violence, and psychiatric illness and duration, initial severity, and type of symptoms and comorbidity. Conclusions: CD is amenable to intervention in the Indian setting. Early intervention will give good outcome. Among risk factors identified, four were socially modifiable factors.

Keywords

• comorbidity
• conduct disorder
• poor outcome
• socially modifiable factors