Jayaprakash Raghavan Achari
Government Medical College, India
Title: Determinants of outcome of conduct disorder among children and adolescents in a tertiary level pediatric care setting
Biography
Biography: Jayaprakash Raghavan Achari
Abstract
Background: Children and adolescents with conduct disorder (CD) are heterogeneous population with wide variations in range of symptomatology, severity, age of onset, sub types, prevalence and co-morbidity, functional impairment, response to intervention and outcome. Aim: To describe psychosocial and clinical profile, course and outcome and to identify the risk factors which determine poor outcome of CD among children and adolescents.
Methods: Clinic based prospective follow up study. Consecutive 300 children in age group 6-18 years with CD, attended Behavioral Pediatrics Unit OP was collected, intervened and followed up for one year. Initial and final scores of abnormal psychosocial situation, symptom severity and functional level were assessed. Psychosocial and clinical profile, clinical course, clinically significant outcome were studied by descriptive statistics followed by significant test for hypothesis. Determinants of poor outcome of CD were identified by logistic regression.
Results: There was significant male dominance (4:1). Majority was of childhood onset type (76.7%). Main psycho social problems were single parent family (18%), family history of alcoholism (15%), domestic violence (5.3%), both together (22.4%) and psychiatric illness (8.4%). Most common complaint was ‘often argues with adults’ (99.33%). Important co-morbidities were hyperkinetic disorder (66.7%) and mixed disorders of conduct & emotion (17.3%). Clinically significant improvement (50% or more reduction in RBPC score) was observed among 64.51% of study population at the end of follow up.
Conclusion: Determinants of poor outcome of CD were single parent family, family history of alcoholism, domestic violence and psychiatric illness, conduct symptom namely ‘’has used a weapon that can cause serious harm to others’’, co-morbid hyperkinetic disorder, mixed disorders of conduct and emotion, duration of CD and initial severity of symptoms.
Keywords: Behavioral Pediatrics Unit (BPU); conduct disorder (CD); childhood and adolescent onset type of CD; Abnormal psychosocial situation; symptom severity; functional impairment and determinants of poor outcome