Disruptive behavior disorders in childhood and adolescence: diagnosis and treatment

作者：de la Pena Olvera Francisco^*; Palacios Cruz Lino

来源：Salud Mental, 2011, 34(5): 421-427.

• Disruptive behavior
• diagnosis
• treatment
• children adolescents

Disruptive behavior disorders (DBD) in childhood and adolescence are among the most frequent reasons for consultation and counseling.
In Oppositional Defiant Disorder (ODD), psychosocial management is the therapeutic intervention of choice. Training parents and caregivers in the behavioral management of the child or early adolescent (12 to 15 years) is the best interventions. Behavioral perspective needs to cover all contexts: family, school, and the child. The clinician must make an individualized treatment plan. The parents suggested interventions should be based on those with the greatest empirical evidence. The use of drugs may be useful as an addition to psychosocial interventions for symptomatic treatment and comorbid conditions. Severe and persistent ODD may require prolonged and intensive treatment. Brief interventions are usually ineffective.
Conduct disorder (CD) is a mixed manifestation that needs biological, psychological and social therapeutic intervention. Psychopharmacological treatment alone is never enough. Studies with drugs for the treatment of CC may be grouped by type of drug used: mood stabilizers, antipsychotics and stimulants. The overall effect size of psychotropic agents in the treatment of aggression is 0.56. Currently only three psychosocial treatments have been adequately evaluated: A) Training for parents, B) Cognitive training in problem-solving skills and C) Multisystemic therapy.
Conclusions
ODD and CD are among he most frequent and severe mental disorders in childhood and adolescence. The treatment of these conditions must be multimodal or multisystemic, including pharmacological, psychoeducational and psychotherapy.

• 出版日期2011-10