Nonpharmacological response in hospitalized children with conduct disorder.
Nonpharmacological response in hospitalized children with conduct disorder.
复制标题
行为障碍住院儿童的非药物反应。
DOI：
10.1097/00004583-199702000-00015
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Campbell,M
中科院分区：
文献类型：
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作者：
Malone,RP;Luebbert,JF;Delaney,MA;Biesecker,KA;Blaney,BL;Rowan,AB;Campbell,M
目的研究住院治疗对因慢性严重攻击性行为住院的品行障碍儿童的影响和/或对安慰剂的反应的研究很少。然而，许多患有这种问题的儿童被送往医院，并立即开始药物治疗。研究对象为44例(男37例，女7例)品行障碍儿童，年龄9.83~17.14岁，因慢性严重攻击行为而住院。这是一项为期4周的双盲和安慰剂对照研究，为期2周的单盲安慰剂导入期。在为期两周的安慰剂基准期内，使用显性攻击性量表对攻击性进行24小时测量。结果在44名受试者中，23名(52.3%)符合进入治疗期的攻击标准(基线无反应者)，21名(47.7%)不符合进入治疗期的攻击性标准(基线响应者)。因此，几乎一半的受试者在没有服用积极药物的情况下，受益于住院环境/结构和/或安慰剂。结论该发现具有重要的治疗和研究意义。治疗攻击性的药物不应在住院后立即开始，因为与住院相关的改善可能不准确地归因于药物治疗，从而导致不必要的儿童用药。安慰剂基准期对于降低有关攻击性的药理学研究中第二类错误的风险至关重要。
OBJECTIVEThere is a paucity of research regarding the effects of hospitalization and/or the response to placebo in children with conduct disorder who are hospitalized for chronic and severe aggression. However, many children with this problem are hospitalized and immediately begin pharmacotherapy. In this report, the effects of hospitalization and placebo administration were examined.METHODSubjects were forty-four children (37 males, 7 females) with conduct disorder, aged 9.83 to 17.14 years, who were hospitalized for chronic and severe aggression. This was a 4-week double-blind and placebo-controlled study with a 2-week single-blind placebo lead-in period. During the 2-week placebo baseline period, aggression was measured on a 24-hour basis, using the Overt Aggression Scale. Only subjects meeting a specific aggression criterion were randomized to the treatment period of the trial.RESULTSOf the 44 subjects enrolled, 23 (52.3%) met the aggression criteria for entering the treatment period (baseline nonresponders), while 21 (47.7%) did not (baseline responders). Thus, almost half of the subjects, while taking no active medication, benefited from the inpatient milieu/structure and/or placebo.CONCLUSIONThis finding has important treatment and research implications. Medication to treat aggression should not be initiated immediately upon hospitalization because improvements associated with hospitalization may be attributed inaccurately to pharmacotherapy, resulting in unnecessarily medicating children. A placebo baseline period is essential to decrease the risk of a type II error in pharmacological research concerning aggression.