LITHIUM IN HOSPITALIZED AGGRESSIVE-CHILDREN WITH CONDUCT DISORDER - ADOUBLE-BLIND AND PLACEBO-CONTROLLED STUDY

Objective: To assess critically the efficacy and safety of lithium and replicate earlier findings in a larger sample of aggressive children with conduct disorder and to assess the utility of the Profile of Mood States (POMS) in this population. Method: Children hospitalized for t reatment-refractory severe aggressiveness and explosiveness and with d iagnosed conduct disorder were subjects in this double-blind, placebo- controlled clinical trial. After a 2-week placebo baseline period, chi ldren were randomly assigned to lithium or placebo treatment for 6 wee ks followed by 2 weeks of placebo. The main outcome measures were the Global Clinical Judgments (Consensus) Scale, Children's Psychiatric Ra ting Scale, Conners Teacher Questionnaire, Parent-Teacher Questionnair e, and the POMS. Results: Fifty children (mean age 9.4 years) complete d this study. The mean optimal daily dose of lithium was 1,248 mg and the mean serum level was 1.12 mEq/L. Lithium was superior to placebo, although the effects on some measures were more modest than in a previ ous study. Conclusions: Lithium appears to be an effective treatment f or some severely aggressive children with conduct disorder. Although t he POMS appeared to be reliable, it did not detect any response to lit hium.