Therapeutics of aggression in children

This paper examines the phenomenology, aetiology and therapeutics of childhood aggression that arises as part of a disruptive behaviour disorder. Phenomenology is discussed with an emphasis on treatment implications. Reviewed studies show that aggressive behaviour exhibits both episodicity and considerable individual stability. Aetiological theories are reviewed with emphasis on the interplay between biological and socio-environmental factors. Both factors are centrally involved in the development and treatment of aggression. A review of double-blind, placebo-controlled medication studies is presented. A computer-based, literature search using Medline and PsychInfo was conducted to locate all potentially relevant articles published in the past 20 years. It was found that there are various treatments available for reducing paediatric aggression including psychotherapeutic and psychopharmacological treatments. There are data to support the use of psychostimulants, lithium and antipsychotics, while data for other agents are only beginning to accumulate. Various pharmacological treatments can reduce aggression in children. However, given the role of both biological and social factors in the development of aggression, multimodal treatment may ultimately provide maximal benefits.