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Gepubliceerd in: Journal of Autism and Developmental Disorders 9/2008

01-10-2008 | Editorial Notes

Beware of Over-Interpreting Negative Trials

Auteurs: Lawrence Scahill, Michael G. Aman, James T. McCracken, Christopher J. McDougle, Benedetto Vitiello

Gepubliceerd in: Journal of Autism and Developmental Disorders | Uitgave 9/2008

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Excerpt

The report by Tyrer et al. ( 2008) raises questions about the fit between study aims and study design. The study randomly assigned adults with intellectual disability to either risperidone ( N = 29), haloperidol ( N = 28) or placebo ( N = 29) under double blind conditions. The primary target of treatment was aggressive behavior as measured by the Modified Overt Aggression Scale (MOAS) (Ratey and Gutheil 1991). The investigators note that aggressive behavior is a frequent problem in this population, that antipsychotic medications are commonly used in clinical practice and that the evidence supporting their use to treat aggression in this population is meager. The investigators conducted a pragmatic trial that included a relatively broad range of subjects across a range of settings. We agree with current practice guidelines that antipsychotic medications should not be administered without careful consideration of alternative treatments and documented evidence of recurring episodes of aggression (Rush and Frances 2000). It is not clear that the subjects in this study satisfied these clinical criteria. Therefore, the results of this study are difficult to interpret and fail to provide much direction for clinicians and families faced with trying to manage aggressive behavior in developmentally disabled adults. …
Literatuur
go back to reference Ratey, J. J., & Gutheil, C. M. (1991). The measurement of aggressive behavior: reflections on the use of the Overt Aggression Scale and the modified Overt Aggression Scale. The Journal of neuropsychiatry and clinical neurosciences, 3, S57–S60. PubMed Ratey, J. J., & Gutheil, C. M. (1991). The measurement of aggressive behavior: reflections on the use of the Overt Aggression Scale and the modified Overt Aggression Scale. The Journal of neuropsychiatry and clinical neurosciences, 3, S57–S60. PubMed
go back to reference Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. (2002). Risperidone in children with autism for serious behavioral problems. New England Journal of Medicine, 347(5), 314–321. CrossRef Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. (2002). Risperidone in children with autism for serious behavioral problems. New England Journal of Medicine, 347(5), 314–321. CrossRef
go back to reference Rush, J., & Frances, A. (Eds.) (2000). Expert consensus guideline series. Treatment of psychiatric and behavioral problems in mental retardation. American Journal on Mental Retardation, 105, 159–228. Rush, J., & Frances, A. (Eds.) (2000). Expert consensus guideline series. Treatment of psychiatric and behavioral problems in mental retardation. American Journal on Mental Retardation, 105, 159–228.
go back to reference Tunis, S. R., Stryer, D. B., & Clancy, C. M. (2003). Practical clinical trials: Increasing the value of clinical research for decision making in clinical and health policy. JAMA, 290(12), 1624–1632. PubMedCrossRef Tunis, S. R., Stryer, D. B., & Clancy, C. M. (2003). Practical clinical trials: Increasing the value of clinical research for decision making in clinical and health policy. JAMA, 290(12), 1624–1632. PubMedCrossRef
go back to reference Tyrer P., Oliver-Africano, P. C., Ahmed, Z., et al. (2008) Risperidone, haloperidol and placebo in the treatment of aggressive and challenging behavior in patients with intellectual disability: A randomized trial. Lancet, 371, 57–64. PubMedCrossRef Tyrer P., Oliver-Africano, P. C., Ahmed, Z., et al. (2008) Risperidone, haloperidol and placebo in the treatment of aggressive and challenging behavior in patients with intellectual disability: A randomized trial. Lancet, 371, 57–64. PubMedCrossRef
Metagegevens
Titel
Beware of Over-Interpreting Negative Trials
Auteurs
Lawrence Scahill
Michael G. Aman
James T. McCracken
Christopher J. McDougle
Benedetto Vitiello
Publicatiedatum
01-10-2008
Uitgeverij
Springer US
Gepubliceerd in
Journal of Autism and Developmental Disorders / Uitgave 9/2008
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI
https://doi.org/10.1007/s10803-008-0581-7

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