Disruptive Behavioral Disorders

00:01 Let's talk a little bit about child psychiatry now.

00:04 When it comes to disruptive behavioral disorders, there are a couple that you should know about for your boards.

00:10 Conduct disorder and also oppositional defiant disorder.

00:14 Let's go through the difference in each one.

00:16 A conduct disorder is a pattern of behavior that involves violation of the basic rights of others and also of social norms and rules.

00:27 Conduct disorder is a common diagnosis in outpatient child psychiatry clinics and it often occurs in boys more than girls and there's a high risk of developing anti social personality disorder in adulthood.

00:41 Remember, to qualify for a diagnosis of anti-social personality disorder it's actually a requirement that a patient show evidence of conduct disorder before the age 15.

00:53 There is an increase co morbidity of ADHD, mood disorders, substance disorders, and criminal activity as an adult. Now, let's take a look at oppositional defiant disorder.

01:06 This is a disruptive behavior but it does not impinge on the rights of another person.

01:13 The prevalence is up to 20% in children less than 6, usually starts before puberty.

01:19 It's more common in boys. We'll remit in about 25% of children but some may progress to develop conduct disorder.

01:28 The treatment for behavioral disorders include psychotherapy, behavioral modification, problem-solving skills, and parent skills teaching.

01:38 So basically it's a wrap around approach to the care of the child.

01:42 The thing that separates oppositional defiant disorder from conduct disorder, and this is very important, is that oppositional defiant disorder does not violate anyone's rights.

01:54 Let's look at the diagnostic criterion, for ODD there's a pattern of anger and irritability.

02:02 People are argumentative and defiant or vindictive and it lasts for at least 6 months and is exhibited during an interaction with at least one individual who's not a sibling.

02:15 It also requires an angry or irritable mood, loss of temper, being touchy or easily annoyed and often being angry and resentful, argumentative, and arguing with authority figures in particular.

02:31 Often defying rules or refusing to comply with the requests from authority figures, often deliberately annoying others, and sometimes blaming others for his or her mistakes.

02:44 There is vindictiveness, being spiteful. The disturbance is associated with distress and social, educational, and occupational functioning. And the behavior does not exclusively occur during the course of a psychotic episode, substance abuse, or a mood disorder.