Pharmacotherapy of disruptive behavior and item changes on a standardized rating scale: pooled analysis of

Michael Aman1, Jan Buitelaar, Goedele De Smedt

  • 1The Nisonger Center, Ohio State University, Columbus, Ohio 4310, USA. aman.1@osu.edu

Insights

Risperidone improved social competence and problem behaviors in children with disruptive behavior disorders (DBDs). However, symptoms of affective insecurity and social disinterest were unaffected by the medication.

Area of Science:

  • Child and Adolescent Psychiatry
  • Behavioral Science
  • Pharmacology

Background:

  • Disruptive behavior disorders (DBDs) involve persistent antisocial and aggressive behaviors violating age-appropriate norms.
  • Risperidone is an approved medication for treating DBDs in various age groups.
  • Assessing risperidone's efficacy on specific symptom items in DBD patients is crucial.

Purpose of the Study:

  • To evaluate the clinical effect of risperidone on Nisonger Child Behavior Rating Form (N-CBRF) symptom items in children with DBDs.
  • To determine which specific behavioral symptoms respond to risperidone treatment.

Main Methods:

  • Pooled data from two 6-week, randomized, double-blind, placebo-controlled trials.
  • Participants were children with DBDs and subaverage IQ (mild, moderate mental retardation, borderline IQ).
  • Risperidone oral solution was administered at doses of 0.02-0.06 mg/kg/day.

Main Results:

  • Risperidone significantly improved both Social Competence and Problem Behavior subscales of the N-CBRF.
  • Symptom reduction was observed in Conduct Problem and Insecure/Anxious categories.
  • Positive social behaviors improved, but 'affective insecurity' symptoms (e.g., shy, tearful) and social disinterest did not.

Conclusions:

  • Risperidone effectively treats most problem behaviors in children with DBDs and subaverage IQ.
  • Specific symptoms like 'affective insecurity' and social disinterest may not respond to risperidone.
  • Findings offer a more nuanced understanding of risperidone's therapeutic profile in this population.
Abstract

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