The high costs of aggression: public expenditures resulting from conduct disorder

Am J Public Health. 2005 Oct;95(10):1767-72. doi: 10.2105/AJPH.2004.061424. Epub 2005 Aug 30.


Objectives: We explored the economic implications of conduct disorder (CD) among adolescents in 4 poor communities in the United States. We examined a range of expenditures related to this disorder across multiple public sectors, including mental health, general health, school, and juvenile justice.

Methods: We used self- and parental-report data to estimate expenditures during a 7-year period in late adolescence of a sample of youths. We contrasted expenditures for youths with CD and youths with oppositional defiant disorder, elevated symptoms (no CD diagnosis), and all others. Diagnosis was determined with a structured assessment.

Results: Additional public costs per child related to CD exceeded $70000 over a 7-year period.

Conclusions: Public expenditures on youths with CD are substantially larger than for youths with closely related conditions, reflecting the importance of prevention and early treatment for the disorder.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Health Services / economics
  • Ambulatory Care / economics
  • Attention Deficit and Disruptive Behavior Disorders / economics
  • Case-Control Studies
  • Conduct Disorder / diagnosis
  • Conduct Disorder / economics*
  • Conduct Disorder / epidemiology
  • Conduct Disorder / therapy
  • Cost of Illness*
  • Criminal Law / economics
  • Female
  • Health Care Surveys
  • Health Expenditures / statistics & numerical data*
  • Hospitalization / economics
  • Humans
  • Juvenile Delinquency / economics*
  • Longitudinal Studies
  • Male
  • Mental Health Services / economics
  • Poverty Areas
  • Public Health / economics*
  • Risk Factors
  • School Health Services / economics
  • Surveys and Questionnaires
  • United States / epidemiology