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.

中文翻译：

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品行障碍的儿童和青少年的侵略性药理治疗。残酷的情绪低落特性会调节药物的功效吗？

背景

行为障碍（CD）的儿童和青少年表现出反复和持续的攻击行为模式，而更为严重的形式通常与无情的（CU）性格特征相关。

目标

为了系统地审查并在有足够数据的情况下，考虑到CU特质的影响，对CD对儿童和青少年侵略性药物的疗效进行荟萃分析。

结果

很少有研究调查以CD为主要诊断的患者，其中很少能区分不同类型的侵略或报告的CU特性指标。在随机对照试验中，哌醋甲酯和利培酮对侵略的影响最大。其他抗精神病药在CD上显示出临床疗效，但这一证据主要是通过开放标签试验揭示的。有一些低质量的证据支持情绪稳定剂和其他药物的微小作用。只有两篇论文描述了CU特质的影响，因此无法提供结论性的结果。

结论

考虑到疾病的异质性，需要更多的概念验证性临床研究来定义药物的作用和CU特质的作用。