Review: limited evidence that risperidone reduces aggression and conduct problems in the short term in children and adolescents with disruptive behaviour disorders

IntroductionDisruptive behaviour disorders are common among children and adolescents, with negative impacts on the youths, their families and society. Although multiple psychosocial treatments are effective in decreasing the symptoms of disruptive behaviour disorders, comprehensive evidence regarding the comparative efficacy and acceptability between these treatments is still lacking. Therefore, we propose a systematic review and network meta-analysis, integrating both direct and indirect comparisons to obtain a hierarchy of treatment efficacy and acceptability.Methods and analysisThe present protocol will be reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Ten databases, including Web of Science, PubMed, PsycINFO, MEDLINE, APA PsycArticles, Psychology and Behavioral Sciences Collection, OpenDissertations, The Cochrane Library, Embase and CINAHL, will be searched from inception for randomised controlled trials of psychosocial treatments for children and adolescents with disruptive behaviour disorders, without restrictions on language, publication year and status. The primary outcomes will be efficacy at post-treatment (severity of disruptive behaviour disorders at post-treatment) and acceptability (dropout rate for any reason) of psychosocial treatments. The secondary outcomes will involve efficacy at follow-up, severity of internalising problems and improvement of social functioning. Two authors will independently conduct the study selection and data extraction, assess the risk of bias using the revised Cochrane Collaboration’s Risk of Bias tool and evaluate the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation framework to network meta-analysis. We will perform Bayesian network meta-analyses with a random effects model. Subgroup and sensitivity analyses will be performed to evaluate the robustness of the findings.Ethics and disseminationThe research does not require ethical approval. Results are planned to be published in journals or presented at conferences. The network meta-analysis will provide information on a hierarchy of treatment efficacy and acceptability and help make a clinical treatment choice.PROSPERO registration numberCRD42020197448.

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Profile of stress factors associated with mental disorders in children and adolescents referred for evaluation and treatment to the Free State Psychiatric Complex, 2007

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v18i2.328 ◽

2012 ◽

Vol 18 (2) ◽

pp. 7

Author(s):

H Heckler ◽

C E Taute ◽

G H J Krüger ◽

D De Wet ◽

F J W Calitz ◽

...

Keyword(s):

Mental Disorders ◽

Children And Adolescents ◽

Developmental Disorders ◽

Depressive Disorders ◽

Conduct Disorders ◽

Stress Factors ◽

Free State ◽

Disruptive Behaviour ◽

State Psychiatric ◽

Disruptive Behaviour Disorders

Introduction. South African children and adolescents face serious challenges. Over the past decades children have been exposed to rapid and stressful changes in their environment, including increased crime and violence. Aim of study. The aim of the study was to determine the profile of stress factors leading to mental disorders in children and adolescents referred to the Child and Adolescent Unit at the Free State Psychiatric Complex, Bloemfontein, from January 2006 to December 2007. Methods. A total of 669 children (0 - 12 years) and adolescents (13 - 18 years) referred to the unit for evaluation and treatment were included in the study. Results. Thirty per cent were diagnosed with attention deficit and disruptive behaviour disorders, followed by major depressive disorders (22.7%), anxiety disorders (18.5%), conduct disorders (16.1%), mild mental retardation (15.7%), adjustment disorders (9.6%), elimination disorders (8.8%), developmental disorders (7.6%) and bereavement (7.0%). Social stressors were identified in 64.1% of participants, and psychological stressors in 19%.Conclusions. Stress plays an important role in the lives of children and adolescents, which could lead to emotional problems if not well managed. The functioning of children and adolescents should be monitored continuously. Schools are in a favourable position to identify stressors affecting children and adolescents. Educators therefore need training and opportunities to consult on mental health matters. Furthermore, religious organisations should be enlisted to identify stressors manifesting as spiritual dysfunction. School health services can play a role in the recognition of biological stressors such as epilepsy, pregnancy, enuresis, illness, speech problems and sensory dysfunction.

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A Profile of Children and Adolescents in a Psychiatric Unit: Multidomain Impairment and Research Implications

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048679709062681 ◽

1997 ◽

Vol 31 (5) ◽

pp. 682-690 ◽

Cited By ~ 8

Author(s):

Roger Paterson ◽

Peta Bauer ◽

C. Ann McDonald ◽

Brett McDermott

Keyword(s):

Children And Adolescents ◽

Psychiatric Treatment ◽

Psychiatric Inpatient ◽

Self Report ◽

High Rate ◽

Disruptive Behaviour ◽

Patient Profile ◽

Disruptive Behaviour Disorders ◽

Psychiatric Conditions ◽

Living Skills

Objective: The scientific literature has not kept pace with the evolution of child and adolescent psychiatric inpatient units, including their nature, patient profile, philosophical orientation and efficacy. This study aims to establish a comprehensive, mul-timodal description of the population served by an inpatient psychiatric treatment facility for children and adolescents. Method: A multidisciplinary assessment regime including psychiatric, medical, speech and language examination, observer rating and patient self-report of psy-chopathology was used to assess 58 consecutive patients over a 20-month period. Results: In addition to a prevalence of disruptive behaviour disorders of 67% and a high rate of comorbidity with other psychiatric conditions, a breadth of impairment was demonstrated in many areas. Significantly decreased measures of socialisation, communication, daily living skills, self-esteem, intelligence and physical health are reported. Moderate to severe language handicap was found in 40% of patients. Conclusions: The inpatient population of children and adolescents exhibited not only a high rate of disruptive behaviour disorders, frequently cornorbid with other psychiatric conditions, but also high levels of physical, speech, language and living skills impairment. This finding supports the need for multimodal, multidisciplinary evaluation and treatment in this population. Outcome research evaluating treatment effectiveness must also account for the wide-ranging disabilities of these children and adolescents.

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Bipolar Disorder in Children and Adolescents: Current Challenges

The Canadian Journal of Psychiatry ◽

10.1177/070674379704200610 ◽

1997 ◽

Vol 42 (6) ◽

pp. 632-636 ◽

Cited By ~ 11

Author(s):

Margaret Steele ◽

Sandra Fisman

Keyword(s):

Bipolar Disorder ◽

Children And Adolescents ◽

Lithium Carbonate ◽

Mood Stabilizers ◽

Disruptive Behaviour ◽

Juvenile Onset ◽

Case Examples ◽

Developmental Factors ◽

Disruptive Behaviour Disorders ◽

Case Vignettes

Objective: To demonstrate the diagnostic and treatment challenges in juvenile-onset bipolar disorder. Method: Three case vignettes are outlined to demonstrate different bipolar presentations in children and adolescents. Results: These case examples illustrate important issues in the diagnosis and management of juvenile-onset bipolar disorder. These issues include diagnostic confusion with atypical initial presentation and the effect of developmental factors on symptom expression. The relationship among genetic risk, early affective instability, and the stress generated by affectively ill family members is complex and circular. Comorbidity with disruptive behaviour disorders, as well as anxiety disorders, is demonstrated by the cases discussed. Comorbid disorders may affect outcome and require separate treatment intervention. There is evidence for the prophylactic antimanic effect of lithium carbonate in children and adolescents, but its specificity as an antimanic agent is still uncertain. There is less evidence, at present, for effectiveness of other mood stabilizers in this age group, although sodium valproate may prove more effective in mixed mania and rapid cycling, which are so often seen with early-onset bipolar disorder. Conclusions: While the existence of juvenile-onset bipolar disorder is no longer in dispute, several outstanding issues related to diagnosis and long-term management remain. Careful prospective research will be necessary to sort out these issues definitively.

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State Empathy in Young Male Adolescents with Disruptive Behaviour Disorders

PsycEXTRA Dataset ◽

10.1037/e554382012-010 ◽

2008 ◽

Author(s):

Minet de Wied ◽

Anton van Boxtel ◽

Walter Matthys ◽

Wim Meeus

Keyword(s):

Young Male ◽

Disruptive Behaviour ◽

Male Adolescents ◽

Disruptive Behaviour Disorders

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Personality dynamics at work: The effects of form, time, and context of variability

European Journal of Personality ◽

10.1177/08902070211017341 ◽

2021 ◽

pp. 089020702110173

Author(s):

Nadin Beckmann ◽

Damian P Birney ◽

Amirali Minbashian ◽

Jens F Beckmann

Keyword(s):

Individual Differences ◽

Cognitive Ability ◽

Temporal Stability ◽

Limited Evidence ◽

Short Term ◽

State Data ◽

The Status ◽

Over Time ◽

Trait Variability

The study aimed to investigate the status of within-person state variability in neuroticism and conscientiousness as individual differences constructs by exploring their (a) temporal stability, (b) cross-context consistency, (c) empirical links to selected antecedents, and (d) empirical links to longer term trait variability. Employing a sample of professionals ( N = 346) from Australian organisations, personality state data together with situation appraisals were collected using experience sampling methodology in field and repeatedly in lab-like settings. Data on personality traits, cognitive ability, and motivational mindsets were collected at baseline and after two years. Contingent (situation contingencies) and non-contingent (relative SD) state variability indices were relatively stable over time and across contexts. Only a small number of predictive effects of state variability were observed, and these differed across contexts. Cognitive ability appeared to be associated with state variability under lab-like conditions. There was limited evidence of links between short-term state and long-term trait variability, except for a small effect for neuroticism. Some evidence of positive manifold was found for non-contingent variability. Systematic efforts are required to further elucidate the complex pattern of results regarding the antecedents, correlates and outcomes of individual differences in state variability.

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Implementation and evaluation of a curriculum on the assessment and treatment of disruptive behaviour disorders

Paediatrics & Child Health ◽

10.1093/pch/pxab008 ◽

2021 ◽

Author(s):

Asif Doja ◽

Tamara Pringsheim ◽

Brendan F Andrade ◽

Lindsay Cowley ◽

Sarah A Healy ◽

...

Keyword(s):

Atypical Antipsychotics ◽

Disruptive Behaviour ◽

Hyperactivity Disorder ◽

Disruptive Mood Dysregulation Disorder ◽

Post Evaluation ◽

Oppositional Defiant ◽

Disruptive Behaviour Disorders ◽

Adequate Education ◽

Assessment And Treatment ◽

Paediatric Practice

Abstract Disruptive behaviour disorders (DBDs)—which can include or be comorbid with disorders such as attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder and disruptive mood dysregulation disorder—are commonly seen in paediatric practice. Given increases in the prescribing of atypical antipsychotics for children and youth, it is imperative that paediatric trainees in Canada receive adequate education on the optimal treatment of DBDs. We describe the development, dissemination, and evaluation of a novel paediatric resident curriculum for the assessment and treatment of DBDs in children and adolescents. Pre–post-evaluation of the curriculum showed improved knowledge in participants.

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