Psychopharmacol Bull
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Psychopharmacol Bull · Jan 1994
Randomized Controlled Trial Clinical TrialPlacebo response in aggressive children with conduct disorder.
Aggressiveness and explosiveness characterize a subgroup of children diagnosed with conduct disorder (CD). Few double-blind, placebo-controlled studies have been conducted in aggressive children with CD, and no study has differentiated placebo responders from nonresponders. This study examined factors that may differentiate placebo responders from nonresponders hospitalized in a structured setting. ⋯ Responders were compared to nonresponders with respect to a detrimental psychosocial environmental score, age, IQ, and baseline ratings on the Children's Psychiatric Rating Scale and Clinical Global Impressions. Responders had significantly higher detrimental psychosocial environmental scores than nonresponders; they were particularly more likely to come from violent homes and to have criminally charged parents. Demographic variables did not distinguish the two groups; however, even mild hyperactivity was associated with poorer response to placebo.
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Psychopharmacol Bull · Jan 1994
Clinical TrialThe Overt Aggression Scale in a study of lithium in aggressive conduct disorder.
This article describes an open study of lithium carbonate in conduct-disordered children. The objective of the study was to investigate the effectiveness of lithium in reducing aggression and the usefulness of the Overt Aggression Scale (OAS), as a measure of treatment effect. The subjects, 8 children, ages 9.2 to 16.9 years (mean +/- standard deviation [SD] = 12.48 +/- 2.97), were treated for 4 weeks with lithium. ⋯ OAS results indicated that aggression decreased significantly over time. The findings from the OAS agreed with findings from a more general measure, the Global Clinical Consensus Rating, leading to the conclusion that the OAS is a promising outcome measure for treatment studies of aggression in children. Further placebo-controlled studies of lithium carbonate in reducing aggressive behavior in conduct-disordered children, employing a specific measure such as the OAS, are warranted.
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Psychopharmacol Bull · Jan 1994
Review5HT1A receptors and pharmacotherapy. Is serotonin receptor down-regulation linked to the mechanism of action of antidepressant drugs?
Numerous observations support the notion that serotonin (5-hydroxytryptamine; 5-HT) and its multiple receptor subtypes are linked not only to the biological basis of depression, but also to the mechanism of action of antidepressant drugs. A general hypothesis of 5-HT receptor dysregulation in depression suggests that 5-HT1A receptors may be down-regulated, whereas 5-HT2 receptors may be up-regulated and display an inadequate ability to convert receptor occupancy by 5-HT into an adequate physiological response. ⋯ In some cases this down-regulation correlates with measures of clinical antidepressant responsiveness. This correlation supports the hypothesis that down-regulation of 5-HT receptors, particularly the 1A and 2 subtypes, may be linked to the mechanism of action of numerous antidepressant drugs.