Stephen Scott is Professor of Child Health and Behaviour at the Institute of Psychiatry (De Crespigny Park, London SE5 8AF, UK. Email: s.scott{at}iop.kcl.ac.uk) and head of the National Specialist Conduct Problems Clinic. His interests include devising interventions and evaluating their effectiveness while trying to uncover the mechanisms through which they work. He is a contributor, with Professor Sir Michael Rutter and others, to the fifth edition of the authoritative text Child and Adolescent Psychiatry, due out in 2008.
Childhood conduct disorder casts a long shadow over adulthood, often leading to antisocial personality, drug misuse, increased rates of psychosis and earlier death. This article reviews a range of effective treatments, and shows what is ineffective. The common theme underlying interventions that work is that they change the environment around the young person, with parent training emerging as the most effective. Medication is largely ineffective. The task now is to enable more of these interventions to be available at a reasonably early age.