Practice Guidelines

Recognition, intervention, and management of antisocial behaviour and conduct disorders in children and young people: summary of NICE-SCIE guidance

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1298 (Published 27 March 2013) Cite this as: BMJ 2013;346:f1298
  1. Stephen Pilling, director1, professor 23,
  2. Nick Gould, consultant4, emeritus professor5, professor6,
  3. Craig Whittington, associate director (clinical effectiveness); lead systematic reviewer1,
  4. Clare Taylor, senior editor7,
  5. Stephen Scott, professor8, consultant child and adolescent psychiatrist; head9, director10
  6. On behalf of the Guideline Development Group
  1. 1National Collaborating Centre for Mental Health, University College London, London WC1E 7HB, UK
  2. 2Centre for Outcomes Research and Effectiveness, University College London, London WC1E 7HB, UK
  3. 3Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 7HB, UK
  4. 4Social Care Institute for Excellence, London SW1Y 5BH, UK
  5. 5Department of Social and Policy Sciences, University of Bath, Bath BA2 7AY, UK
  6. 6School of Human Services and Social Work, Griffith University, QLD 4131, Australia
  7. 7National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London E1 8AA, UK
  8. 8Institute of Psychiatry, King’s College London, London SE5 8AF, UK
  9. 9National Conduct Problems Clinic and National Adoption and Fostering Clinic, Maudsley Hospital, London BR3 3BX, UK
  10. 10National Academy for Parenting Research, King’s College London, London SE5 8AF, UK
  1. Correspondence to: S Pilling s.pilling{at}ucl.ac.uk

Antisocial behaviour and conduct disorders (including oppositional defiant disorder and conduct disorder) are the most common mental and behavioural problems in children and young people globally, with the frequency increasing in Western countries.1 In the United Kingdom 5% of mental and behavioural problems in children and young people (≤ 18 years) meet criteria for a conduct disorder, as do almost 40% of looked-after children, children who have been abused, and those on child protection or safeguarding registers.2 Conduct disorders are strongly associated with poor performance at school, social isolation, substance misuse, and involvement with the criminal justice system.3 A large proportion of children and young people with a conduct disorder will go on to be antisocial adults with impoverished and destructive lifestyles,3 especially if the conduct problems develop early,4 and a large minority will be diagnosed with antisocial personality disorder.5 Antisocial behaviour and conduct disorders often coexist with other mental health problems, place a heavy personal and economic burden on individuals and society,6 and involve a wide range of health, social care, educational, and criminal justice services.

This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on recognising and managing antisocial behaviour and conduct disorders in children and young people.7 The guideline was developed jointly with the Social Care Institute for Excellence (SCIE).

Recommendations

NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets.

Working safely and effectively

Health and social care professionals working with children and young people who present with behaviour suggestive of a conduct disorder, …

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