Review Paper Medication Strategies in Childhood Aggression: A Review

practice Aggression is defined as outward destructive behaviourthat results from the confluence of longer-term factors (for example, biological, psychological, personality, family, peer, school, and community), short-term influences (for example, internal states of anger, boredom, or intoxication), and situational variables (that is, conflict, opportunity, and blockage of goals or needs) (1). Violence is overt and inten-tional aggression that includes hitting, choking, kicking, throwing objects, using a weapon, forcing sex, verbally threatening, and destroying property. This behaviour impoverishes children’s relationships in various spheres of their lives. Aggressive behaviour in children is very common in referred samples. Aggressive and other antisocial behaviours typically account for up to 50 % of all child and adolescent psychiatric referrals (2). Such children usually have a myriad of psychiat-ric, psychological, educational, legal, peer, and familial diffi-culties and impairments. Several effective psychosocial interventions are emerging (3). Consistently effective and Can J Psychiatry, Vol 48, No 6, July 2003 367 Objective: To review studies of psychopharmacological management of aggression in common childhood psychiatric disorders. Method: Using OVID software, we searched Medline for studies that were undertaken in the last 30 years. Controlled and uncontrolled data are summarized for each condition. Results: A paucity of evidence-based information currently exists. Even so, specific indi-cations from the existing literature can be suggested for several classes of psychotropics, particularly in conduct disorder (CD), attention-deficit hyperactivity disorder (ADHD), mood disorders, and other conditions. Conclusions: Clinicians can use findings from reviewed controlled and, where necessary, uncontrolled studies to inform pharmacologic practice. This review offers suggestions for future research directions that will aid clinical practice. (Can J Psychiatry 2003;48:367–373) Information on author affiliations appears at the end of the article