Behandling av maladaptiv aggresjon hos ungdom: CERT-retningslinjer II.

Treatment of Maladaptive Aggression in Youth: CERT Guidelines II. Treatments and Ongoing Management

Forfattere
Rosato, N. S. Correll, C. U. Pappadopulos, E. Chait, A. Crystal, S. Jensen, P. S. Treatment of Maladaptive Aggressive in Youth Steering Committee
Årstall
2012
Tidsskrift
Pediatrics
Volum
129
Sider
E1577-E1586
OBJECTIVE: To develop guidelines for management and treatment of maladaptive aggression in youth in the areas of psychosocial interventions, medication treatments, and side-effect management. METHODS: Evidence was assembled and evaluated in a multistep process, including systematic reviews of published literature; an expert survey of recommended practices; a consensus conference of researchers, policymakers, clinicians, and family advocates; and review by the steering committee of successive drafts of the recommendations. The Center for Education and Research on Mental Health Therapeutics Treatment of Maladaptive Aggression in Youth guidelines reflect a synthesis of the available evidence, based on this multistep process. RESULTS: This article describes the content, rationale, and evidence for 11 recommendations. Key treatment principles include considering psychosocial interventions, such as evidence-based parent and child skills training as the first line of treatment; targeting the underlying disorder first following evidence-based guidelines; considering individual psychosocial and medical factors, including cardiovascular risk in the selection of agents if medication treatment (ideally with the best evidence base) is initiated; avoiding the use of multiple psychotropic medications simultaneously; and careful monitoring of treatment response, by using structured rating scales, as well as close medical monitoring for side effects, including metabolic changes. CONCLUSIONS: Treatment of children with maladaptive aggression is a "moving target" requiring ongoing assimilation of new evidence as it emerges. Based on the existing evidence, the Treatment of Maladaptive Aggression in Youth guidelines provide a framework for management of maladaptive aggression in youth, appropriate for use by primary care clinicians and mental health providers. Pediatrics 2012;129:e1577-e1586

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Atferdsproblemer

Antisosial atferd (vold/aggresjon, ungdomskriminalitet)

Tiltak

Psykologiske behandlingsmetoder

Familieterapi

Foreldreveiledning/-terapi (feks COS, ICDP)

Medikamentell behandling

Antidepressiva

Stimulerende midler

Antipsykotisk medisin

Aldersgruppe

Barn i førskolealder (3-5 år)

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

Uklar aldersgruppe

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