TY  - JOUR
A1  - Konrad, Kerstin
A1  - Kohls, Gregor
A1  - Baumann, Sarah
A1  - Bernhard, Anka
A1  - Martinelli, Anne
A1  - Ackermann, Katharina
A1  - Smaragdi, Areti
A1  - Gonzalez-Madruga, Karen
A1  - Wells, Amy
A1  - Rogers, Jack C.
A1  - Pauli, Ruth
A1  - Clanton, Roberta
A1  - Baker, Rosalind
A1  - Kersten, Linda
A1  - Prätzlich, Martin
A1  - Oldenhof, Helena
A1  - Jansen, Lucres
A1  - Kleeven, Anneke
A1  - Bigorra, Aitana
A1  - Hervás, Amaia
A1  - Kerexeta-Lizeaga, Iñaki
A1  - Sesma-Pardo, Eva
A1  - Gonzalez-Torres, Miguel Angel
A1  - Siklósi, Réka
A1  - Dochnal, Roberta
A1  - Kalogerakis, Zacharias
A1  - Pirlympou, Mara
A1  - Papadakos, Leonidas
A1  - Cornwell, Harriet
A1  - Scharke, Wolfgang
A1  - Dikeos, Dimitris
A1  - Fernández-Rivas, Aranzazu
A1  - Popma, Arne
A1  - Stadler, Christina
A1  - Herpertz-Dahlmann, Beate
A1  - De Brito, Stephane A.
A1  - Fairchild, Graeme
A1  - Freitag, Christine M.
T1  - Sex differences in psychiatric comorbidity and clinical presentation in youths with conduct disorder
T2  - The journal of child psychology and psychiatry
N2  - Background: Conduct disorder (CD) rarely occurs alone but is typically accompanied by comorbid psychiatric disorders, which complicates the clinical presentation and treatment of affected youths. The aim of this study was to investigate sex differences in comorbidity pattern in CD and to systematically explore the ‘gender paradox’ and ‘delayed-onset pathway’ hypotheses of female CD.
Methods: As part of the FemNAT-CD multisite study, semistructured clinical interviews and rating scales were used to perform a comprehensive phenotypic characterization of 454 girls and 295 boys with CD (9–18 years), compared to 864 sex- and age-matched typically developing controls.
Results: Girls with CD exhibited higher rates of current major depression, anxiety disorders, post-traumatic stress disorder and borderline personality disorder, whereas boys with CD had higher rates of current attention-deficit/hyperactivity disorder. In line with the ‘gender paradox’ hypothesis, relative to boys, girls with CD showed significantly more lifetime psychiatric comorbidities (incl. Alcohol Use Disorder), which were accompanied by more severe CD symptoms. Female and male youths with CD also differed significantly in their CD symptom profiles and distribution of age-of-onset subtypes of CD (i.e. fewer girls with childhood-onset CD). In line with the ‘delayed-onset pathway’ hypothesis, girls with adolescent-onset CD showed similar levels of dimensional psychopathology like boys with childhood-onset CD, while boys with adolescent-onset CD had the lowest levels of internalizing psychopathology.
Conclusions: Within the largest study of CD in girls performed to date, we found compelling evidence for sex differences in comorbidity patterns and clinical presentation of CD. Our findings further support aspects of the ‘gender paradox’ and ‘delayed-onset pathway’ hypotheses by showing that girls with CD had higher rates of comorbid lifetime mental disorders and functional impairments, and they usually developed CD during adolescence. These novel data on sex-specific clinical profiles of CD will be critical in informing intervention and prevention programmes.
KW  - conduct disorder
KW  - sex differences
KW  - psychiatric comorbidity
KW  - callous-unemotional traits
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/61881
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-618811
SN  - 1469-7610
VL  - 2021
IS  - Online Version of Record before inclusion in an issue
SP  - 1
EP  - 11
PB  - Wiley-Blackwell
CY  - Oxford
ER  -