Study designs of evaluations included in the review
Randomised controlled trials (RCTs) published after the release of the DSM-III (1980) were eligible for inclusion.
Specific interventions included in the review
Studies of any medication used for the treatment of disruptive behaviour disorders were eligible for the review. Studies using an augmenting medication in addition to the medication under study were excluded. The included studies involved anticonvulsants, antipsychotics, lithium, stimulants and other medications (atomoxetine, clonidine and methylphenidate). Treatment duration ranged from 2 weeks to 6 months.
Participants included in the review
Studies of children (0 to 10 years) and adolescents (11 to 18 years) diagnosed with disruptive behaviour disorders according to the DSM (American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorder) or ICD (International Classification of Diseases) criteria were eligible for the review. Trials of participants with a diagnosis of hyperkinetic disorder were excluded. The participants in the included studies had diagnoses of conduct disorder, disruptive behaviour disorder or oppositional defiant disorder. The participants in some studies also had attention deficit hyperactivity disorder or below average IQ. The participants were aged from 4 to 18 years.
Outcomes assessed in the review
The primary outcomes of interest were treatment response and reduction in global symptom severity, measured using the Clinical Global Impression improvement and severity scales. Secondary outcomes included reduction in aggression measured on validated scales and the number of patients discontinuing treatment because of drug-related adverse events. When trials used multiple sources of information to rate outcomes, clinician ratings were preferred, followed by teacher and parent ratings.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection