Consensus report on impulsive aggression as a symptom across diagnostic categories in child psychiatry: Implications for medication studies
Consensus report on impulsive aggression as a symptom across diagnostic categories in child psychiatry: Implications for medication studies
复制标题
DOI：
10.1097/chi.0b013e31802f1454
复制
发表时间：
2007-03-01
影响因子：
13.3
通讯作者：
Vitiello, Benedetto
中科院分区：
文献类型：
--
作者：
Jensen, Peter S.;Youngstrom, Eric A.;Vitiello, Benedetto
目的：确定冲动性攻击(IA)是否是一个有意义的临床构思，并确定其在不同诊断类别之间是否足够相似，以便跨障碍的平行研究可能成为寻求适应症的适当证据。如果是这样的话，应该如何评估IA、设计药理学研究以及解决伦理问题？方法：来自关键利益相关者社区的专家，包括学术临床医生、研究人员、执业临床医生、美国食品和药物管理局、国家精神卫生研究所、行业赞助商以及患者和家庭倡导者，于2004年11月4日和5日举行了为期两天的共识会议。在评估了关于当前研究证据的摘要陈述后，参与者被分配到三个工作组，检查核心问题，并在各自领域形成共识指导方针。工作组全体成员讨论了工作组的建议，以达成共识，然后由作者在会后会议上进一步重复和浓缩成这份报告。结果：与会者一致认为，IA是一个重要的公共卫生和临床问题，构成了多种疾病的关键治疗目标，并且可以足够精确地进行药理学研究。达成共识的其他领域涉及措施类型、最佳研究设计和伦理要求。结论：根据科学证据和临床经验，这些共识驱动的建议可以指导未来研究的设计。
Objective: To determine whether impulsive aggression (IA) is a meaningful clinical construct and to ascertain whether it is sufficiently similar across diagnostic categories, such that parallel studies across disorders might constitute appropriate evidence for pursuing indications. If so, how should IA be assessed, pharmacological studies designed, and ethical issues addressed? Method: Experts from key stakeholder communities, including academic clinicians, researchers, practicing clinicians, U.S. Food and Drug Administration, National Institute of Mental Health, industry sponsors, and patient and family advocates, met for a 2-day consensus conference on November 4 and 5, 2004. After evaluating summary presentations on current research evidence, participants were assigned to three workgroups, examined core issues, and generated consensus guidelines in their areas. Workgroup recommendations were discussed by the whole group to reach consensus, and then further iterated and condensed into this report postconference by the authors. Results: Conference participants agreed that IA is a substantial public health and clinical concern, constitutes a key therapeutic target across multiple disorders, and can be measured with sufficient precision that pharmacological studies are warranted. Additional areas of consensus concerned types of measures, optimal study designs, and ethical imperatives. Conclusion: Derived from scientific evidence and clinical experience, these consensus-driven recommendations can guide the design of future studies.