Introduction

Cost and outcomes

Conduct disorder in early childhood can be responsible for scholastic failure, poor peer relations and delinquency in adolescence. It can severely impair individual development and social functioning, and a substantial proportion of children with conduct disorder go on to have psychiatric and other medical problems in adult life, including ‘phobia, major depressive disorders, obsessive-compulsive disorder, schizophrenia, panic disorder, manic episodes and somatisation’ (Maughan & Rutter, 1998). They also have a higher risk of poor social functioning, alcohol and substance use rates, unemployment, broken marriages, criminality and imprisonment.

Each of these common childhood and adulthood consequences of conduct disorder has a personal and a social cost: there are potential losses (costs) to the person with conduct disorder, to their family and to the wider society. Some of these losses are direct economic costs and some are more indirect. Treatments or other interventions intended to tackle the conditions or disorders underlying these personal and social problems are themselves costly because of the need to devote staff time, office space and other resources to support and care.

Of course, the treatments and other interventions which professional staff provide to children and families would be expected to generate beneficial effects – to reduce the amount of antisocial behaviour, to improve peer relations and personal development, to reduce the likelihood of social and personal problems in adulthood, and so on. Different interventions by health care and other bodies could produce different effects.