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

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Question

Question: Are atypical antipsychotics effective and safe for treating disruptive behaviour disorders in children and young people?

Outcomes: Primary outcomes: aggression (measured using eg, aberrant behaviour checklist (ABC) Irritability Scale, overt aggression scale (OAS), overt aggression scale-modified (OAS-M)), conduct problems (measured using eg, Nisonger Child Behaviour Rating Form—Conduct Problem (NCBRF-CP), Conners’ Parent Rating Scale—Conduct Problem (CPRS-CP)), weight gain or change in body mass index (BMI) and metabolic parameters (adverse events).

Methods

Design: Systematic review and meta-analysis.

Data sources: CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL, ClinicalTrials.gov, Australian New Zealand Clinical Trials Registry, CenterWatch and ICTRP were searched in August 2011.

Study selection and analysis: Double-blind randomised clinical trails (RCTs) including children and adolescents (≤18 years) with a diagnosis of a disruptive behaviour disorder (including oppositional defiant disorder, conduct disorder and unspecified disruptive behaviour disorder).Participants could have comorbid attention-deficit hyperactivity disorder (ADHD), major depression or an anxiety disorder, but trials were excluded if participants had a comorbid diagnosis of pervasive developmental disorder, autistic spectrum disorder, psychotic disorder or bipolar affective disorder.Meta-analyses were performed if studies were sufficiently similar. Random effects models were used. Continuous data were analysed …

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