Psychopharmacologic strategies for the treatment of aggression in juveniles.
Maladaptive aggression in youth is one of the most common and troublesome reasons for referrals to child psychiatrists. It has a complex relationship with psychopathology. There are several syndromes, which are primary disturbances of clustered maladaptive aggression, most notably oppositional defiant disorder and conduct disorder. However, problems with aggression also appear in a wide range of other disturbances, such as bipolar disorder, posttraumatic stress disorder, and mood disorders. Additionally, aggression is normative, serves an adaptive purpose and can be situationally induced. These complexities need to be carefully addressed before targeting maladaptive aggression psychopharmacologically. We summarize the literature on the psychopharmacology of maladaptive aggression in youth, focusing on disorders without cognitive impairment. We delineate the subtypes of aggression which are most likely to respond to medication (reactive-affective-defensive-impulsive in their acute and chronic form) and conclude with a discussion of specific medication strategies which are supported by controlled clinical trials and clinical experience.
Steiner
Hans
H
Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Child Development, Stanford University School of Medicine, California 94503, USA. steiner@stanford.edu
Saxena
Kirti
K
Chang
Kiki
K
D000293:Adolescent; D000367:Age Factors; D000374:Aggression / Q000187:drug effects* / Q000523:psychology; D019955:Conduct Disorder / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012917:Social Adjustment
D011619:Psychotropic Drugs