Diagnostic Changes for Conduct Disorder Across DSM and ICD Versions
Critical Limitation of Available Evidence
The provided evidence does not contain specific information detailing the diagnostic criteria changes for Conduct Disorder across DSM-III, DSM-III-TR, DSM-IV, DSM-5, DSM-5-TR, ICD-10, and ICD-11. The available literature focuses primarily on assessment approaches, contextual factors in diagnosis, and related disorders (particularly Oppositional Defiant Disorder), but does not systematically compare the evolution of Conduct Disorder criteria across these classification systems.
What We Know From Available Evidence
DSM-IV Structure
- DSM-IV defined Conduct Disorder with 15 distinct behavioral symptoms including truancy and association with deviant peers that clinicians used to evaluate the disorder 1
- The 15 symptoms in DSM-IV were used as the basis for diagnostic evaluation, with clinicians applying contextual information differently to specific symptoms 2
DSM-5 Introduction of Callous-Unemotional Specifier
- DSM-5 introduced a specifier for Conduct Disorder with callous-unemotional (CU) presentation, representing the most significant documented change in recent diagnostic criteria 3
- This CU specifier captures the affective dimension of psychopathy in youth, including lack of empathy, sense of guilt, and shallow emotion 4
- The core diagnostic criteria for Conduct Disorder remained unchanged in DSM-5, but the CU specifier allows for meaningful subtyping of more severe antisocial and aggressive behaviors 3
ICD-10 Classification
- ICD-10 did not list Intermittent Explosive Disorder as a separate category, highlighting a distinction from impulsive aggression disorders 1
ICD-11 General Improvements
- ICD-11 expanded from 11 to 21 disorder groupings in the mental, behavioral, and neurodevelopmental disorders chapter 1
- ICD-11 introduced dimensional severity specifications (mild, moderate, severe) for several disorders to improve clinical utility and global applicability 1
- However, specific changes to Conduct Disorder classification in ICD-11 are not detailed in the available evidence 1
Assessment Approach Across All Versions
Multi-Informant Requirement
- A systematic, multi-informant assessment gathering information from parents, teachers, and the youth themselves using developmentally appropriate methods is recommended across all diagnostic systems 1
- Informant discrepancies are expected and should be evaluated rather than viewed as invalidating the diagnosis 1
- Clinicians commonly consider contextual factors such as association with deviant peers when diagnosing Conduct Disorder 2
Core Diagnostic Features (Consistent Across Versions)
- Primary diagnostic features include aggression toward people or animals, destruction of property, deceitfulness or theft, and serious violations of rules 5, 6
- At least three symptoms must be present in the past 12 months, with at least one present in the past six months to diagnose Conduct Disorder 5
- These behaviors must occur for at least a six-month period 6
Important Clinical Caveat
The absence of detailed comparative information across DSM-III, DSM-III-TR, and the transition points between major versions represents a significant gap in the provided evidence. For comprehensive understanding of these historical changes, consultation of the actual DSM and ICD manuals or systematic reviews specifically addressing diagnostic criteria evolution would be necessary.