In the systematic review «Pringsheim T, Hirsch L, Gardner D ym. The pharmaco...»1 regarding the pharmacological management of oppositional behaviour, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder, altogether 40 RCT studies with 2364 participants comparing psychostimulants with placebo were included. Summary of the studies is shown in Table «Psychostimulants for aggression, oppositional behaviour, and conduct problems in youth with ADHD, with and without ODD and CD....»1.
|Outcome||Number of studies and patients||Duration of studies||Summary of findings|
conduct problems measured by rating scales
|2–16 weeks||Studies 1970 to 2001
Effect size (Cohen d)
Clinician 0.77, 95 % CI 0.63 to 0.88
Parent 0.71, 95 % CI 0.42 to 1.15
Teacher 1.04, 95 % CI 0.79 to 1.32
Studies 2002 to 2013*
Parent 0.55, 95 % CI 0.36 to 0.73
Teacher 0.84, 95 % CI 0.59 to 1.10
|*Based on 8 studies that provided adequate data on end point scores to be included in a meta-analysis|
There were some limitations in the quality of included studies. No serious inconsistency, indirectness or imprecision was noticed. Publication bias was unlikely. Evidence of dose–response effect for this outcome was reported. Measures of aggression, oppositional behaviour, and conduct problems were included as a secondary outcome in all studies performed between 2002 and 2013. Most studies included children with ADHD alone, ADHD with ODD, or ADHD with CD, none of them subanalyzed results based on diagnostic groups. Nonetheless, the presence of comorbid ODD or CD (serious disruptive, aggressive symptoms) correlated negatively with effect size.