Tvp22 01 omslag kijk verder

Tijdschrift voor Psychiatrie 42 (2000) 10, 739 - 749


Oppositional-defiant disorder, conduct disorder and delinquency in adolescence: Clinical description, comorbidity, forensic assessment and treatment

Th.A.H. Doreleijers

background In the last decade of the 20th century much scientific research has been carried out on the etiology and pathogenesis of disruptive disorders, and on the effects of treatment focussed on these disorders. More than before this research has been carried out from the child and adolescent point of view.
aims The aim of this article is to provide a review of the literature, larded with clinical experiences. It is the second part of a two-part review of disruptive disorders in children and adolescents.
method Review of the national and international literature. The first article dealt extensively with risk factors and pathogenesis of disruptive disorders; this article highlights the comorbid conditions in adolescents, the forensic diagnostic assessment, and the for this age group specific treatment methods .
results The phenomenology of disruptive disorders in adolescents is marked by comorbid conditions like adhd, depression, substance abuse, etcetera. Disruptive disorders as well as juvenile delinquency follow specific, predictable developmental pathways. For diagnostic assessment gathering of information from more than one informant is obligatory.
conclusions Disruptive disorders with comorbid conditions are serious disorders with an unfavorable prognosis if diagnostic assessment and treatment are carried out too late: outcome studies elicit all kinds of psychiatric disorders, antisocial personality disorders included.

keywords adolescents, aggression, comorbidity, conduct disorder, delinquency, oppositional-defiant disorder