The pharmacological treatment of aggression in children and adolescents with conduct disorder. Do callous-unemotional traits modulate the efficacy of medication?

Carla Balia, Sara Carucci (Lead / Corresponding author), David Coghill, Alessandro Zuddas

    Research output: Contribution to journalReview article

    12 Citations (Scopus)

    Abstract

    Background: Children and adolescents with conduct disorder (CD) show repetitive and persistent patterns of aggressive behaviour and the more severe forms are often associated with callous-unemotional (CU) traits.

    Objectives: To systematically review and, where data are adequate, conduct meta-analyses on the efficacy of medication on aggression in children and adolescent with CD considering the impact of CU traits.

    Results: Few studies have investigated patients with CD as primary diagnosis, and few of these have discriminated between different types of aggression or reported measures of CU traits. Methylphenidate and risperidone showed the largest effects on aggression in randomized controlled trials; other antipsychotics showed clinical efficacy on CD but this evidence is mainly revealed by open label trials. There is some low quality evidence to support a small effect of mood stabilizers and other agents. There were only two papers describing the effects of CU traits thus providing inconclusive results.

    Conclusion: Considering heterogeneity of the disorder, more proof-of-concept clinical studies are needed to define effects of medication and role of CU traits.

    Original languageEnglish
    Pages (from-to)218-238
    Number of pages21
    JournalNeuroscience and Biobehavioral Reviews
    Volume91
    Early online date27 Jan 2017
    DOIs
    Publication statusPublished - Aug 2018

    Fingerprint

    Conduct Disorder
    Aggression
    Pharmacology
    Methylphenidate
    Risperidone
    Therapeutics
    Antipsychotic Agents
    Meta-Analysis
    Randomized Controlled Trials

    Keywords

    • Conduct disorder
    • Callous unemotional traits
    • Methylphenidate
    • Risperidone
    • Stimulants
    • Antipsychotics
    • Lithium

    Cite this

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    title = "The pharmacological treatment of aggression in children and adolescents with conduct disorder. Do callous-unemotional traits modulate the efficacy of medication?",
    abstract = "Background: Children and adolescents with conduct disorder (CD) show repetitive and persistent patterns of aggressive behaviour and the more severe forms are often associated with callous-unemotional (CU) traits.Objectives: To systematically review and, where data are adequate, conduct meta-analyses on the efficacy of medication on aggression in children and adolescent with CD considering the impact of CU traits.Results: Few studies have investigated patients with CD as primary diagnosis, and few of these have discriminated between different types of aggression or reported measures of CU traits. Methylphenidate and risperidone showed the largest effects on aggression in randomized controlled trials; other antipsychotics showed clinical efficacy on CD but this evidence is mainly revealed by open label trials. There is some low quality evidence to support a small effect of mood stabilizers and other agents. There were only two papers describing the effects of CU traits thus providing inconclusive results.Conclusion: Considering heterogeneity of the disorder, more proof-of-concept clinical studies are needed to define effects of medication and role of CU traits.",
    keywords = "Conduct disorder, Callous unemotional traits , Methylphenidate , Risperidone, Stimulants , Antipsychotics, Lithium",
    author = "Carla Balia and Sara Carucci and David Coghill and Alessandro Zuddas",
    note = "The paper is part of the MATRICS research project (Multidisciplinary Approaches to Translational Research In Conduct Syndromes; http://matrics-project.eu/). The project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no 603016.",
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    The pharmacological treatment of aggression in children and adolescents with conduct disorder. Do callous-unemotional traits modulate the efficacy of medication? / Balia, Carla; Carucci, Sara (Lead / Corresponding author); Coghill, David; Zuddas, Alessandro.

    In: Neuroscience and Biobehavioral Reviews, Vol. 91, 08.2018, p. 218-238.

    Research output: Contribution to journalReview article

    TY - JOUR

    T1 - The pharmacological treatment of aggression in children and adolescents with conduct disorder. Do callous-unemotional traits modulate the efficacy of medication?

    AU - Balia, Carla

    AU - Carucci, Sara

    AU - Coghill, David

    AU - Zuddas, Alessandro

    N1 - The paper is part of the MATRICS research project (Multidisciplinary Approaches to Translational Research In Conduct Syndromes; http://matrics-project.eu/). The project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no 603016.

    PY - 2018/8

    Y1 - 2018/8

    N2 - Background: Children and adolescents with conduct disorder (CD) show repetitive and persistent patterns of aggressive behaviour and the more severe forms are often associated with callous-unemotional (CU) traits.Objectives: To systematically review and, where data are adequate, conduct meta-analyses on the efficacy of medication on aggression in children and adolescent with CD considering the impact of CU traits.Results: Few studies have investigated patients with CD as primary diagnosis, and few of these have discriminated between different types of aggression or reported measures of CU traits. Methylphenidate and risperidone showed the largest effects on aggression in randomized controlled trials; other antipsychotics showed clinical efficacy on CD but this evidence is mainly revealed by open label trials. There is some low quality evidence to support a small effect of mood stabilizers and other agents. There were only two papers describing the effects of CU traits thus providing inconclusive results.Conclusion: Considering heterogeneity of the disorder, more proof-of-concept clinical studies are needed to define effects of medication and role of CU traits.

    AB - Background: Children and adolescents with conduct disorder (CD) show repetitive and persistent patterns of aggressive behaviour and the more severe forms are often associated with callous-unemotional (CU) traits.Objectives: To systematically review and, where data are adequate, conduct meta-analyses on the efficacy of medication on aggression in children and adolescent with CD considering the impact of CU traits.Results: Few studies have investigated patients with CD as primary diagnosis, and few of these have discriminated between different types of aggression or reported measures of CU traits. Methylphenidate and risperidone showed the largest effects on aggression in randomized controlled trials; other antipsychotics showed clinical efficacy on CD but this evidence is mainly revealed by open label trials. There is some low quality evidence to support a small effect of mood stabilizers and other agents. There were only two papers describing the effects of CU traits thus providing inconclusive results.Conclusion: Considering heterogeneity of the disorder, more proof-of-concept clinical studies are needed to define effects of medication and role of CU traits.

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    KW - Methylphenidate

    KW - Risperidone

    KW - Stimulants

    KW - Antipsychotics

    KW - Lithium

    U2 - 10.1016/j.neubiorev.2017.01.024

    DO - 10.1016/j.neubiorev.2017.01.024

    M3 - Review article

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    EP - 238

    JO - Neuroscience and Biobehavioral Reviews

    JF - Neuroscience and Biobehavioral Reviews

    SN - 0149-7634

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