Children aggressive symptoms

After kidney transplantation, 15 of 20 children tolerated tacrolimus after switching from ciclosporin for immunological reasons or adverse effects (609). The most frequent adverse effects were neuropsychological and behavioral symptoms in three children, ranging from anorexia nervosa-like symptoms, with weight loss, amenorrhea, depression, and school problems, to severe insomnia and in one child aggressive and anxious behavior. Only the last child was exposed to toxic tacrolimus blood concentrations. All the adverse effects were fully reversible after withdrawal. 

Pfeffer, C.R., Jiang H., and Domeshek, L.J. (1997) Buspirone treatment of psychiatrically hospitalized prepubertal children with symptoms of anxiey and moderately severe aggression. J Child Adolesc Psychopharmacol 7 145—155. 

Aggression is an important component of mood disorders. Thus, a measure that captures the frequency and severity of the child s outbursts, such as the Overt Aggression Scale (OAS Yudofsky et ah, 1986), may be useful. This rating was evaluated in one inpatient study, and appears to be reliable and valid (Kafantaris et ah, 1996). Behavior disorder rating scales that measure ADHD and ODD are also likely to be useful. As noted above, our clinic uses a combined Child and Adolescent Symptom Inventory both at baseline and to follow treatment response, as it provides a comprehensive rating of symptoms (Grayson and Carlson, 1991 Gadow et al., 1999). 

Because the symptoms are so disruptive to the family and to the child, conduct disorder is one of the most common reasons for referral to a pediatrician or child psychiatrist. In patients with MR, this disorder is seen less as organized, planned illicit activities and more as impulsive, unpredictable acts of violence or destruction. Such individuals may exhibit aggression toward caregivers, teachers, family members, or themselves, and they may be emotionally labile. If behavior therapy has not been effective, pharmacological treatment may be necessary. 

Clinical outcomes before, during and after treatments were assessed in six multiple domains represented by 19 separate measures. The domains were ADHD symptoms aggression-oppositional defiant disorder internalizing symptoms social skills parent child relations and cognitive performance (measured with three subscales of the Wechsler Individual Achievement test readmg, mathematics, spelling). 

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