Department of Cognitive Neuroscience, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, PO Box 9101, (204) 6500 HB, Nijmegen, The Netherlands.
Eur Child Adolesc Psychiatry. 2013 Feb;22 Suppl 1:S49-54. doi: 10.1007/s00787-012-0361-y.
Conduct disorder (CD) is a frequently occurring psychiatric disorder characterized by a persistent pattern of aggressive and non-aggressive rule breaking antisocial behaviours that lead to considerable burden for the patients themselves, their family and society. This review paper updates diagnostic and therapeutic approaches to CD in the light of the forthcoming DSM-5 definition. The diagnostic criteria for CD will remain unchanged in DSM-5, but the introduction of a specifier of CD with a callous-unemotional (CU) presentation is new. Linked to this, we discuss the pros and cons of various other ways to subtype aggression/CD symptoms. Existing guidelines for CD are, with few exceptions, already of a relatively older date and emphasize that clinical assessment should be systematic and comprehensive and based on a multi-informant approach. Non-medical psychosocial interventions are recommended as the first option for the treatment of CD. There is a role for medication in the treatment of comorbid syndromes and/or in case of insufficient response to psychosocial interventions and severe and dangerous aggressive and violent behaviours.
品行障碍(CD)是一种常见的精神障碍,其特征是持续存在的攻击性和非攻击性违反规则的反社会行为模式,给患者自身、他们的家庭和社会带来了相当大的负担。本文综述了根据即将发布的 DSM-5 定义更新的 CD 的诊断和治疗方法。DSM-5 中 CD 的诊断标准保持不变,但引入了一种具有无情冷漠(CU)表现的 CD 特定表现。与此相关,我们讨论了各种其他亚类攻击/CD 症状的优缺点。现有的 CD 指南,除了少数例外,已经相对陈旧,强调临床评估应该是系统和全面的,并基于多信息来源的方法。非医疗心理社会干预被推荐作为 CD 的首选治疗方法。对于共病综合征的治疗,以及/或者对于心理社会干预反应不足和严重危险的攻击和暴力行为,药物治疗有一定的作用。