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Antisocial Behaviour and Conduct Disorders in Children and Young People

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Antisocial Behaviour and Conduct Disorders in Children and Young People ANTISOCIAL BEHAVIOUR AND CONDUCT DISORDERS IN CHILDREN AND YOUNG PEOPLE THE NICE GUIDELINE ON RECOGNITION, intervention AND MANAGEMENT Update information April 2017: Four research recommendations were identified as out of date in the 2017 surveillance review, and have been deleted. These changes can be seen in the short version of the guideline available at: http://www.nice.org.uk/guidance/cg158 ANTISOCIAL BEHAVIOUR AND CONDUCT DISORDERS IN CHILDREN AND YOUNG PEOPLE RECOGNITION, INTERVENTION AND MANAGEMENT National Clinical Guideline Number 158 National Collaborating Centre for Mental Health and Social Care Institute for Excellence commissioned by the National Institute for Health and Care Excellence published by The British Psychological Society and The Royal College of Psychiatrists 2608.indb 1 8/5/2013 10:56:28 AM © The British Psychological Society & The Royal College of Psychiatrists, 2013 The views presented in this book do not necessarily refl ect those of the British Psychological Society, and the publishers are not responsible for any error of omission or fact. The British Psychological Society is a registered charity (no. 229642). All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Enquiries in this regard should be directed to the British Psychological Society. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library. ISBN-: 978-1-908020-61-1 Printed in Great Britain by Stanley L. Hunt (Printers) Ltd. Additional material: data CD-Rom created by Pix18 (www.pix18.co.uk) developed by National Collaborating Centre for Mental Health The Royal College of Psychiatrists 4th Floor, Standon House 21 Mansell Street London E1 8AA www.nccmh.org.uk commissioned by National Institute for Health and Care Excellence 1st Floor 10 Spring Gardens London SWIX 8PG www.nice.org.uk published by The British Psychological Society St Andrews House 48 Princess Road East Leicester LE1 7DR www.bps.org.uk and The Royal College of Psychiatrists 17 Belgrave Square London SW1X 8PG www.rcpsych.ac.uk 2608.indb 2 8/5/2013 10:56:29 AM Contents CONTENTS GUIDELINE DEVELOPMENT GROUP MEMBERS 5 1 PREFACE 8 1.1 National clinical guidelines 8 1.2 The National Conduct Disorders in Children and Young People guidance 11 2 ANTISOCIAL BEHAVIOUR AND CONDUCT DISORDERS IN CHILDREN AND YOUNG PEOPLE 14 2.1 Introduction 14 2.2 The disorder 15 2.3 Classifi cation 18 2.4 Epidemiology 23 2.5 Aetiology 24 2.6 Course and prognosis 28 2.7 Treatment 31 2.8 General issues when planning treatment 34 2.9 Prevention 34 2.10 Economic cost 35 3 METHODS USED TO DEVELOP THIS GUIDELINE 38 3.1 Overview 38 3.2 The scope 38 3.3 The Guideline Development Group 39 3.4 Review questions 40 3.5 Systematic clinical literature review 42 3.6 Health economics methods 58 3.7 The incorporation and adaptation of existing NICE guideline recommendations 62 3.8 From evidence to recommendations 64 3.9 Stakeholder contributions 65 3.10 Validation of the guideline 66 4 ACCESS TO AND DELIVERY OF SERVICES, AND THE EXPERIENCE OF CARE 67 4.1 Introduction 67 4.2 Evidence review 68 4.3 Review of existing guidance 106 3 2608.indb 3 8/5/2013 10:56:29 AM Contents 4.4 From evidence to recommendations 117 4.5 Recommendations 135 5 SELECTIVE PREVENTION INTERVENTIONS 144 5.1 Introduction 144 5.2 Current practice 147 5.3 Clinical evidence review 148 5.4 Health economic evidence 174 5.5 From evidence to recommendations 174 5.6 Recommendations 175 6 CASE IDENTIFICATION AND ASSESSMENT 177 6.1 Introduction 177 6.2 Clinical evidence review 177 6.3 From evidence to recommendations 198 6.4 Recommendations 203 7 PSYCHOLOGICAL/PSYCHOSOCIAL INDICATED PREVENTION AND TREATMENT INTERVENTIONS 207 7.1 Introduction 207 7.2 Clinical evidence review 208 7.3 Health economic evidence 271 7.4 From evidence to recommendations 301 7.5 Recommendations 303 8 PHARMACOLOGICAL AND PHYSICAL TREATMENT INTERVENTIONS FOR CONDUCT DISORDERS 308 8.1 Introduction 308 8.2 Clinical evidence review 309 8.3 Health economic evidence 326 8.4 From evidence to recommendations 327 8.5 Recommendations 328 9 SUMMARY OF RECOMMENDATIONS 333 9.1 General principles of care 333 9.2 Selective prevention 337 9.3 Identifi cation and assessment 338 9.4 Identifying effective treatment and care options 340 9.5 Psychosocial interventions – treatment and indicated prevention 341 9.6 Pharmacological interventions 344 9.7 Organisation and delivery of care 346 10 APPENDICES 351 11 REFERENCES 429 12 ABBREVIATIONS 465 4 2608.indb 4 8/5/2013 10:56:29 AM Guideline development group members GUIDELINE DEVELOPMENT GROUP MEMBERS Professor Stephen Scott (Chair) Professor of Child Health and Behaviour, Institute of Psychiatry, King’s College London; Consultant Child and Adolescent Psychiatrist & Head, National Conduct Problems Clinic and National Adoption and Fostering Clinic, Maudsley Hospital, London; Director, Multidimensional Treatment Foster Care Project in England; Director, National Academy for Parenting Research Professor Stephen Pilling (Facilitator) Director, National Collaborating Centre for Mental Health; Director, Centre for Outcomes Research and Effectiveness, University College London Professor Nick Gould (Deputy Guideline Chair, representing the Social Care Institute for Excellence) Consultant, Social Care Institute for Excellence; Emeritus Professor of Social Work, University of Bath; Professor of Social Work, Griffi th University, Queensland, Australia Ms Beth Anderson Senior Research Analyst, Social Care Institute for Excellence, London Dr Benedict Anigbogu Health Economist, National Collaborating Centre for Mental Health Ms Sara Barratt Consultant Systemic Psychotherapist; Team Leader, Fostering, Adoption and Kinship Care Team, Tavistock Centre, London Ms Ruth Braidwood Research Assistant (from May 2012), National Collaborating Centre for Mental Health Mrs Maria Brewster Service user and carer representative Dr Barbara Compitus General Practitioner, Bristol 5 2608.indb 5 8/5/2013 10:56:29 AM Guideline development group members Dr Moira Doolan Consultant Systemic Psychotherapist; Lead for interventions: Helping Children Achieve and Safe Studies, National Academy for Parenting Research, Institute of Psychiatry, King’s College London Professor Peter Fonagy Chief Executive, Anna Freud Centre, London; Freud Memorial Professor of Psychoanalysis, University College London Ms Laura Gibbon Project Manager (until December 2011), National Collaborating Centre for Mental Health Ms Naomi Glover Research Assistant (until July 2011), National Collaborating Centre for Mental Health Ms Bronwyn Harrison Research Assistant (until March 2012), National Collaborating Centre for Mental Health Ms Flora Kaminski Research Assistant (until July 2011), National Collaborating Centre for Mental Health Dr Daphne Keen Consultant Developmental Paediatrician, St George’s Hospital, London; Honorary Senior Lecturer, St George’s, University of London Dr Paul McArdle Consultant and Senior Lecturer Child and Adolescent Psychiatry, Newcastle Dr Paul Mitchell Clinical Lead, Hindley Young Offenders Institution Mental Health Team, Manchester Ms Maryla Moulin Project Manager (from January 2012), National Collaborating Centre for Mental Health Dr Rosa Nieto-Hernandez Systematic Reviewer (until September 2011), National Collaborating Centre for Mental Health Ms Melinda Smith Research Assistant (until April 2012), National Collaborating Centre for Mental Health 6 2608.indb 6 8/5/2013 10:56:29 AM Guideline development group members Ms Sarah Stockton Senior Information Scientist, National Collaborating Centre for Mental Health Dr Clare Taylor Senior Editor, National Collaborating Centre for Mental Health Dr Jenny Taylor Consultant Clinical Psychologist; Supervisor of the Hackney site of the Department of Health’s Multi-Systemic Therapy National Research Trial, London Dr Amina Yesufu-Udechuku Systematic Reviewer (until June 2011), National Collaborating Centre for Mental Health Dr Craig Whittington Associate Director (Clinical Effectiveness) and Senior Systematic Reviewer (from October 2011), National Collaborating Centre for Mental Health Mrs Philippa Williams Service user and carer representative Mr Tony Wootton Retired Head Teacher, Millthorpe School, York EDITORIAL ASSISTANCE Ms Liz Allison Deputy Director, Psychoanalysis Unit, Research Department of Clinical, Educational and Health Psychology, University College London Ms Lucy Burt Research Assistant, National Collaborating Centre for Mental Health Dr Ifi geneia Mavranezouli Senior Health Economist, National Collaborating Centre for Mental Health COPY EDITING Ms Nuala Ernest Assistant Editor, National Collaborating Centre for Mental Health 7 2608.indb 7 8/5/2013 10:56:29 AM Preface 1PREFACE This guideline, which is a collaboration between NICE and the Social Care Institute for Excellence (SCIE), has been developed to advise on the recognition, identifi cation and management of conduct disorders (including oppositional defi ant disorder) and associated antisocial behaviour in children and young people. The guideline updates and replaces Parent-Training/Education Programmes in the Management of Children with Conduct Disorders, NICE technology appraisal guidance 102 (NICE, 2006). The guideline recommendations have been developed by a multidisciplinary
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