What is conduct disorder? Are there different types? And more importantly, how can we best treat these patients? This article goes through the topic in a structured and systematic way, so that you can get a lay of this complicated land.
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The diagnosis of conduct disorder started with patients who were generally labeled as “bad kids”—juvenile delinquents, so to speak—and then professionals came to the realization that these kids are not necessarily “bad” but that there may be some kind of psychiatric pathology underlying their actions. In this interview, Akeem Marsh, MD, presents his perspective as a psychiatrist providing diagnostic evaluations, medication management, individual therapy, and treatment planning in a juvenile detention setting in New York City.
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Previous studies have shown that children who are bullied or who bully others are at higher-than-normal risk to have psychiatric disorders as adults. It’s tempting to blame the bullying—but it’s possible that the development of adult problems was driven not by bullying, but rather by preexisting psychiatric disorders in childhood.
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Dr. Joshua Feder studied mathematics and medicine at Boston University, Psychiatry at Naval Regional Medical Center San Diego, serving the first Gulf War in child and adolescent psychiatry fellowship at Tripler Army Medical Center in Honolulu, and eventually became Chief of Child Psychiatry at the National Naval Medical Center in Bethesda, MD. Dr. Feder now practices in Solana Beach, California, and serves as Executive Medical Director at Positive Development, providing relationship-based support for families, with research at UCSD, SDSU, Fielding Graduate University, An Najah National University, Quicksilver Software, Autism Is inclusion program, and Programmatic Lead for the International Networking Group on Peace Building with Young Children, with projects in the US, Northern Ireland, and the Middle East. Dr. Feder co-authored the first American Academy of Child & Adolescent Psychiatry Practice Parameter on Autism and serves as Co-Chair of the Disaster & Trauma Committee at AACAP. Dr Feder was founding policy chair for the California Association for Infant Mental Health and advocates worldwide on access to care, climate policy, and peacebuilding. His recent books include Child Medication Fact Book for Psychiatric Practice, Second Edition (2023) and Prescribing Psychotropics (2021).
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