Disruptive behaviors are a class of predominantly externalizing behaviors that include physical aggression, property destruction, temper outbursts, verbal aggression, and some forms of self-injurious behaviors. Externalizing behaviors are also major components of disruptive, impulse-control and conduct disorders, disruptive mood dysregulation disorder, trauma-related and stressor-related disorders, intermittent explosive disorder, personality disorders, and other neuropsychiatric and neurodevelopmental disorders. Disruptive behaviors and associated disorders are among the most frequent reasons for child behavioral health referrals and are the most common reason for referrals among children with intellectual disabilities. The focus of this paper is on the adjunctive role of integrated psychopharmacological treatment in the management of children with disruptive behaviors and co-occurring intellectual disabilities. The decision-making process for adding pharmacotherapy to a comprehensive treatment plan incorporates not only a working knowledge of basic behavioral neurobiology of disruptive behaviors but also an understanding of the strengths and weaknesses of various pharmacotherapies. Importantly, there is little evidence to support the use of psychopharmacologic agents in managing difficult behaviors in children with intellectual disabilities, but with that said, risperidone has the strongest evidence base for its use.

破坏性行为是一类主要外化的行为，包括身体攻击、财产破坏、脾气暴躁、言语攻击和某些形式的自残行为。外化行为也是破坏性、冲动控制和品行障碍、破坏性情绪失调障碍、创伤相关和压力源相关障碍、间歇性爆发障碍、人格障碍和其他神经精神和神经发育障碍的主要组成部分。破坏性行为和相关疾病是儿童行为健康转诊的最常见原因之一，也是智障儿童转诊的最常见原因。本文的重点是综合精神药理学治疗在管理具有破坏性行为和同时发生智力障碍的儿童中的辅助作用。将药物疗法添加到综合治疗计划的决策过程不仅包括破坏性行为的基本行为神经生物学的工作知识，还包括对各种药物疗法的优缺点的理解。重要的是，几乎没有证据支持使用精神药物治疗智障儿童的困难行为，但话虽如此，利培酮的使用具有最有力的证据基础。将药物疗法添加到综合治疗计划的决策过程不仅包括破坏性行为的基本行为神经生物学的工作知识，还包括对各种药物疗法的优缺点的理解。重要的是，几乎没有证据支持使用精神药物治疗智障儿童的困难行为，但话虽如此，利培酮的使用具有最有力的证据基础。将药物疗法添加到综合治疗计划的决策过程不仅包括破坏性行为的基本行为神经生物学的工作知识，还包括对各种药物疗法的优缺点的理解。重要的是，几乎没有证据支持使用精神药物治疗智障儿童的困难行为，但话虽如此，利培酮的使用具有最有力的证据基础。