The symptoms of conduct disorder include; excessive levels of fighting, cruelty to pets and children, truancy from school and running away from home, delinquency, fire setting and other severe destructive behaviours to properties, repeated lies, persistent severe disobedience to and disrespect for superiors and the law, unusually frequent and severe temper tantrums, maliciousness, impulsivity, substance abuse, defiant provocative behaviour, and crime such as stealing. Children with conduct disorder are seen as bullies and are deceitful, they lack empathy and mostly end up committing crimes that leads to imprisonment. Any one of these categories, if marked, is sufficient for the diagnosis, but isolated dissocial acts are not.

Attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, substance abuse disorder, depressive disorder, bipolar disorder, adjustment reaction to an external stressor, and psychotic disorders like schizophrenia. 

There are several factors that could lead to conduct disorder in children and adolescents. These factors can include; child abuse and neglect, intellectual disability, genetic predisposition, family discord, poor parenting style, family poverty, peer influences, perinatal complications, temperament, and exposure to parental conflict.

There are no specific investigations for conduct disorder, however, it is good to rule out possible differential diagnosis. The DSM5 clearly states the diagnostic criteria for it and diagnosis is clinical.

The first line treatment for children and adolescents with conduct disorder is psychotherapy. Others include; cognitive behavioral therapy, parent management training, family therapy, and behavioral modification. Risperidone has been found to be helpful in reducing aggression while SSRIs a helpful in reducing irritability and mood problems.

Regular follow-up is advised as >25% of these children will have a diagnosis of antisocial personality disorder in adulthood. A majority of them that don’t develop the personality disorder that have a dysfunctional social and behavioral activities as adults.

Conduct disorder can be prevented by adequate fear management in early life, children who cannot adequately manage their emotions often transfer it to other children or pets. Proper parental management is an important factor. Early presentation to the hospital can prevent complications. Children should be well taken care of and child abuse and neglect should be taken seriously. 

Conduct disorder is a serious behavioral disorder in older children and adolescent. It has lifelong consequences if not properly managed. Family dynamics plays an important role in the disorder and such children need proper monitoring and early presentation to a child and adolescent psychiatrist.