Social problem or medical diagnosis

Infringement of the rights of other people is a requirement for the diagnosis of conduct disorder. Since the manifestations include a failure to obey social rules despite an apparently intact mental state and social capacities, many have seen the disorder as principally socially determined. Therefore they believe that the responsibility

Course ..andprognosis

Treatment for its cause and elimination lies with people who can influence the socialization process, such as parents, schoolteachers, social service departments, and politicians. There is some debate within child and adolescent psychiatry as to whether doctors and mental health professionals should be involved in any but the most complex casesA) Some have argued that the involvement of medical personnel carries the risk of their becoming agents of social control through the misapplication of diagnostic labels, which may lead to abuses of the kind seen in some totalitarian regimes.

However, advances in the last decade have shown there are substantial genetic and biological contributions to conduct disorder, and in some cases the symptoms may be responsive to medication. Work in the last 25 years mainly from the field of child and adolescent mental health has clarified many of the mechanisms contributing to the development and persistence of antisocial behaviour, and has led to the development of effective treatments. As yet, these are not being widely used with the children and adolescents who need them. Therefore psychiatrists need to be able to contribute to the planning and delivery of an appropriate service.

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