human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The efficacy and safety of haloperidol , lithium carbonate , and placebo were critically assessed in 61 treatment-resistant , hospitalized children aged 5.2 to 12.9 years with diagnoses of conduct disorder , aggressive type . In this double-blind and well-controlled study , the optimal dosages of haloperidol ranged from 1.0 to 6.0 mg/day and those of lithium carbonate from 500 to 2,000 mg/day . For the assessment of behavioral changes and untoward effects , various rating scales were used in different setting s. Both haloperidol and lithium carbonate were found to be significantly superior to placebo in decreasing behavioral symptoms . Although both medications were clinical ly effective , haloperidol was associated more often with untoward effects than was lithium carbonate OBJECTIVE To examine the relationship between attention deficit disorder with hyperactivity in childhood and criminality in adolescence and adulthood in 89 hyperactive and 87 normal control subjects . METHOD In this prospect i ve study , adolescent follow-up intervals ranged from 13 to 21 years and adult follow-up ranged from 18 to 23 years . The official arrest records for all subjects were obtained . RESULTS Hyperactive subjects had significantly higher juvenile ( 46 % versus 11 % ) and adult ( 21 % versus 1 % ) arrest rates . Juvenile and adult incarceration rates were also significantly higher . Childhood conduct problems predicted later criminality , and serious antisocial behavior in adolescence predicted adult criminality . CONCLUSIONS Hyperactive children are at risk for both juvenile and adult criminality . The risk for becoming an adult offender is associated with conduct problems in childhood and serious antisocial behavior ( repeat offending ) in adolescence . Hyperactive children who do not have conduct problems are not at increased risk for later criminality BACKGROUND Stimulants are not considered appropriate for the treatment of children with conduct disorders ( CDs ) . The postulated differences in stimulant effect between children with attention deficit hyperactivity disorder ( ADHD ) and CD led to the hypothesis that methylpheni date hydrochloride , which is effective in ADHD , would not significantly improve symptoms of CD . METHODS We r and omly assigned 84 children with CD , between the ages of 6 and 15 years , to receive methylpheni date hydrochloride ( up to 60 mg/d ) or placebo for 5 weeks . Behavior was evaluated by parent , teacher , and clinician reports and by direct classroom observations . Two thirds of the children also met criteria for ADHD . RESULTS Contrary to prediction , ratings of antisocial behaviors specific to CD were significantly reduced by methylpheni date treatment . The magnitude of methylpheni date effect indicated meaningful clinical benefit . Partialling out severity of ADHD did not alter the significant superiority of methylpheni date on CD ratings specifically ( P < .001 ) . CONCLUSIONS Methylpheni date has short-term positive effects on children and adolescents with CD . Key aspects of antisocial adjustment appear to be treatment responsive . This effect was independent of severity of the children 's initial ADHD symptoms THE CONCEPT of minimal brain dysfunction ( MBD ) was developed to account for a variety of obscure behavioral abnormalities often considered purely functional in nature . 1 - 4 In a recent review of the subject Pincus and Glaser 2 describe the motor , perceptual , and behavioral characteristics that comprise the MBD syndrome . They state that MBD is a " behavioral diagnosis . " The children afflicted show  " inappropriate activity  , " "  disordered attention span  , " " poorly controlled behavior  , " "  impulsiveness with destructive elements , " " hyperkinesis , " " outbursts of aggression , temper tantrums , sexual displays . " There may be motor , perceptual , reading , and writing impairment , as well as poor ability at copying complex Gestalten . 5 - 7 There is often a history of delayed developmental milestones as well as organic cerebral trauma due to complications of pregnancy , traumatic birth , head trauma , or intracerebral infection after birth . Abnormal behavior such as violent aggressiveness or lack of attention at school may thus be seen as due , in part , to BACKGROUND Prior research indicates that conduct disorder ( CD ) is associated with a range of co-morbid mental disorders . However , the actual prevalence , subtypes and patterns of co-morbidity of DSM-IV-defined CD in the general US population remains unknown . METHOD Retrospective assessment of CD and other DSM-IV disorders was conducted using fully structured diagnostic interviews among a nationally representative sample of respondents ( n=3199 ) in the National Comorbidity Survey Replication ( NCS-R ) . RESULTS The estimated lifetime prevalence of CD in the US is 9.5 % ( 12.0 % among males and 7.1 % among females ) , with a median age-of-onset of 11.6 ( 0.2 ) years . Latent class analysis ( LCA ) identified five CD subtypes characterized by rule violations , deceit/theft , aggression , severe covert behaviors , and pervasive CD symptoms . A dose-response relationship was revealed between CD subtype severity and risk of subsequent disorders . Results also indicated that CD typically precedes mood and substance use disorders , but most often occurs after impulse control and anxiety disorders . Although both active and remitted CD is associated with increased risk of the subsequent first onset of other mental disorders , remitted CD is associated with significantly lower risk of subsequent disorders . CONCLUSIONS CD is prevalent and heterogeneous in the US population , and more severe subtypes and the presence of active CD are associated with higher risk of co-morbid disorders . Future prospect i ve studies using general population sample s will further inform the nature and course of this disorder This article describes an open study of lithium carbonate in conduct-disordered children . The objective of the study was to investigate the effectiveness of lithium in reducing aggression and the usefulness of the Overt Aggression Scale ( OAS ) , as a measure of treatment effect . The subjects , 8 children , ages 9.2 to 16.9 years ( mean + /- st and ard deviation [ SD ] = 12.48 + /- 2.97 ) , were treated for 4 weeks with lithium . Optimal dosages ranged from 1200 to 1800 mg/day ( mean = 1350 + /- 227 ) with corresponding serum lithium levels ranging from 0.86 to 1.39 mEq/L ( mean = 1.05 + /- 0.17 ) . OAS results indicated that aggression decreased significantly over time . The findings from the OAS agreed with findings from a more general measure , the Global Clinical Consensus Rating , leading to the conclusion that the OAS is a promising outcome measure for treatment studies of aggression in children . Further placebo-controlled studies of lithium carbonate in reducing aggressive behavior in conduct-disordered children , employing a specific measure such as the OAS , are warranted 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 . METHODS Children hospitalized for treatment-refractory severe aggressiveness and explosiveness and with diagnosed conduct disorder were subjects in this double-blind , placebo-controlled clinical trial . After a 2-week placebo baseline period , children were r and omly assigned to lithium or placebo treatment for 6 weeks of placebo . The main outcome measures were the Global Clinical Judgments ( Consensus ) Scale , Children 's Psychiatric Rating Scale , Conners Teacher Question naire , Parent-Teacher Question naire , and the POMS . RESULTS Fifty children ( mean age 9.4 years ) completed 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 previous study . CONCLUSIONS Lithium appears to be an effective treatment for some severely aggressive children with conduct disorder . Although the POMS appeared to be reliable , it did not detect any response to lithium One of the least documented " known " effects of methylpheni date in hyperactive children is the suppression of peer aggression . In this study , 11 aggressive-hyperactive children received a low ( 0.3 mg/kg ) and moderate ( 0.6 mg/kg ) dose of methylpheni date and placebo for 2 weeks each under double-blind conditions . Children were observed in public school setting s during classroom seatwork activities , lunch , and recess . Results showed that methylpheni date suppressed nonphysical aggression ( p = 0.06 ) in the classroom , and a moderate dose decreased physical aggression ( p less than 0.01 ) and verbal aggression ( p = 0.07 ) on the playground . The effect on the rate of appropriate social interaction was variable . The majority of subjects exhibited either the same or higher levels of appropriate social interaction on the 0.6 mg/kg dose compared with placebo . In the classroom , both doses of methylpheni date also result ed in reduced levels of motor movement , off-task behavior , noncompliance , and disruptiveness . Teacher ratings of hyperactivity and conduct problem symptoms revealed drug effects , whereas parallel parent instruments did not OBJECTIVE To determine whether risperidone is effective in reducing symptoms of disruptive behaviors ( such as aggression , impulsivity , defiance of authority figures , and property destruction ) associated with conduct disorder , oppositional defiant disorder , and disruptive behavior disorder-not otherwise specified in children with subaverage IQs . METHOD The trial consisted of a 1-week , single-blind , placebo run-in period and was followed by a 6-week , double-blind , placebo-controlled period . One hundred ten children ( aged 5 - 12 years inclusive ) with an IQ of 36 - 84 with a disruptive behavior disorder and a score of at least 24 on the Conduct Problem subscale of the Nisonger Child Behavior Rating Form ( NCBRF ) were enrolled . Eighty percent of subjects had comorbid attention-deficit/hyperactivity disorder ( ADHD ) .  Risperidone doses ranged from 0.02 to 0.06 mg/kg per day . Subjects were rated on the NCBRF , Aberrant Behavior Checklist , Behavior Problems Inventory , Clinical Global Impressions ( CGI ) , modified California Verbal Learning Test ( CVLT ) , and a continuous performance task ( CPT ) . RESULTS The intention-to-treat analysis of risperidone-treated subjects showed a significant ( p < .001 ) reduction in mean scores ( from 33.4 at baseline to 17.6 at end point ; 47.3 % reduction ) versus placebo-treated subjects ( mean baseline of 32.6 to 25.8 at end point ; 20.9 % reduction ) on the Conduct Problem subscale of the NCBRF . Between-group differences in favor of risperidone were seen as early as week 1 and were significant at all post-baseline visits . Other subscales showed significant improvement with risperidone compared with placebo .  CGI scale ratings of improvement showed highly significant gains for risperidone over placebo . A sub analysis demonstrated that the effect of risperidone was unaffected by diagnosis , presence/absence of ADHD , psychostimulant use , IQ status , and somnolence .  Risperidone produced no changes on the cognitive variables ( CPT/modified CVLT ) . The most common side effects included somnolence , headache , appetite increase , and dyspepsia . Side effects related to extrapyramidal symptoms were reported in 7 ( 13.2 % ) and 3 ( 5.3 % ) of the subjects in the risperidone and placebo groups , respectively ( p = .245 ) . CONCLUSIONS Risperidone appears to be an adequately tolerated and effective treatment in children with subaverage IQs and severe disruptive behaviors such as aggression and destructive behavior Much remains to be learned about the adolescent outcomes of clinic-referred boys whose childhood conduct problems are serious enough to meet diagnostic criteria for conduct disorder ( CD ) .  Six structured diagnostic assessment s were conducted over 7 years of 73 clinic-referred 7–12-year-old boys who met criteria for CD in Wave 1 . There were substantial individual differences in the adolescent outcomes of CD , ranging from worsening to sustained recovery , with most boys showing persistent , but fluctuating levels of CD . Improvement in CD was not accounted for by treatment or incarceration , but more positive outcomes over Waves 2–7 were predicted prospect ively with substantial accuracy , using a combination of baseline predictors : less initial severity of CD , fewer symptoms of attention-deficit hyperactivity disorder , higher child verbal intelligence , greater family socioeconomic advantage , and not having antisocial biological parents Treatment-emergent symptoms and behavioral changes were assessed during an 8-week double-blind study comparing molindone and thioridazine in 31 aggressive hospitalized children ( ages 6 - 11 ) .  Molindone was found to be as effective as thioridazine in this sample . Adverse effects differed ( nonsignificantly ) for the two groups , with more sedation in the thioridazine-treated children . Clinical records from 6 adolescent in patients treated with molindone were review ed as a comparison group . Molindone is a relatively safe neuroleptic for child and adolescent in patients because of its short half-life and minimal prolonged tissue accumulation . Additional studies on different child population s are necessary before the proper indications for molindone usage in the pediatric group can be established OBJECTIVE The authors sought to replicate open-label findings showing that specific criteria for explosive temper and mood lability identify disruptive youth who improve while receiving the anticonvulsant divalproex 
    Output:
    
agent
Results There is some evidence of the effectiveness of medication in treating DBDs , with positive outcomes for lithium and risperidone in particular .
Pharmacotherapy also demonstrated some efficacy in reducing symptoms of aggression .
Medication was relatively well-tolerated , as indicated by equivalent dropout rates in medication and comparison groups .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The efficacy and safety of haloperidol , lithium carbonate , and placebo were critically assessed in 61 treatment-resistant , hospitalized children aged 5.2 to 12.9 years with diagnoses of conduct disorder , aggressive type . In this double-blind and well-controlled study , the optimal dosages of haloperidol ranged from 1.0 to 6.0 mg/day and those of lithium carbonate from 500 to 2,000 mg/day . For the assessment of behavioral changes and untoward effects , various rating scales were used in different setting s. Both haloperidol and lithium carbonate were found to be significantly superior to placebo in decreasing behavioral symptoms . Although both medications were clinical ly effective , haloperidol was associated more often with untoward effects than was lithium carbonate OBJECTIVE To examine the relationship between attention deficit disorder with hyperactivity in childhood and criminality in adolescence and adulthood in 89 hyperactive and 87 normal control subjects . METHOD In this prospect i ve study , adolescent follow-up intervals ranged from 13 to 21 years and adult follow-up ranged from 18 to 23 years . The official arrest records for all subjects were obtained . RESULTS Hyperactive subjects had significantly higher juvenile ( 46 % versus 11 % ) and adult ( 21 % versus 1 % ) arrest rates . Juvenile and adult incarceration rates were also significantly higher . Childhood conduct problems predicted later criminality , and serious antisocial behavior in adolescence predicted adult criminality . CONCLUSIONS Hyperactive children are at risk for both juvenile and adult criminality . The risk for becoming an adult offender is associated with conduct problems in childhood and serious antisocial behavior ( repeat offending ) in adolescence . Hyperactive children who do not have conduct problems are not at increased risk for later criminality BACKGROUND Stimulants are not considered appropriate for the treatment of children with conduct disorders ( CDs ) . The postulated differences in stimulant effect between children with attention deficit hyperactivity disorder ( ADHD ) and CD led to the hypothesis that methylpheni date hydrochloride , which is effective in ADHD , would not significantly improve symptoms of CD . METHODS We r and omly assigned 84 children with CD , between the ages of 6 and 15 years , to receive methylpheni date hydrochloride ( up to 60 mg/d ) or placebo for 5 weeks . Behavior was evaluated by parent , teacher , and clinician reports and by direct classroom observations . Two thirds of the children also met criteria for ADHD . RESULTS Contrary to prediction , ratings of antisocial behaviors specific to CD were significantly reduced by methylpheni date treatment . The magnitude of methylpheni date effect indicated meaningful clinical benefit . Partialling out severity of ADHD did not alter the significant superiority of methylpheni date on CD ratings specifically ( P < .001 ) . CONCLUSIONS Methylpheni date has short-term positive effects on children and adolescents with CD . Key aspects of antisocial adjustment appear to be treatment responsive . This effect was independent of severity of the children 's initial ADHD symptoms THE CONCEPT of minimal brain dysfunction ( MBD ) was developed to account for a variety of obscure behavioral abnormalities often considered purely functional in nature . 1 - 4 In a recent review of the subject Pincus and Glaser 2 describe the motor , perceptual , and behavioral characteristics that comprise the MBD syndrome . They state that MBD is a " behavioral diagnosis . " The children afflicted show  " inappropriate activity  , " "  disordered attention span  , " " poorly controlled behavior  , " "  impulsiveness with destructive elements , " " hyperkinesis , " " outbursts of aggression , temper tantrums , sexual displays . " There may be motor , perceptual , reading , and writing impairment , as well as poor ability at copying complex Gestalten . 5 - 7 There is often a history of delayed developmental milestones as well as organic cerebral trauma due to complications of pregnancy , traumatic birth , head trauma , or intracerebral infection after birth . Abnormal behavior such as violent aggressiveness or lack of attention at school may thus be seen as due , in part , to BACKGROUND Prior research indicates that conduct disorder ( CD ) is associated with a range of co-morbid mental disorders . However , the actual prevalence , subtypes and patterns of co-morbidity of DSM-IV-defined CD in the general US population remains unknown . METHOD Retrospective assessment of CD and other DSM-IV disorders was conducted using fully structured diagnostic interviews among a nationally representative sample of respondents ( n=3199 ) in the National Comorbidity Survey Replication ( NCS-R ) . RESULTS The estimated lifetime prevalence of CD in the US is 9.5 % ( 12.0 % among males and 7.1 % among females ) , with a median age-of-onset of 11.6 ( 0.2 ) years . Latent class analysis ( LCA ) identified five CD subtypes characterized by rule violations , deceit/theft , aggression , severe covert behaviors , and pervasive CD symptoms . A dose-response relationship was revealed between CD subtype severity and risk of subsequent disorders . Results also indicated that CD typically precedes mood and substance use disorders , but most often occurs after impulse control and anxiety disorders . Although both active and remitted CD is associated with increased risk of the subsequent first onset of other mental disorders , remitted CD is associated with significantly lower risk of subsequent disorders . CONCLUSIONS CD is prevalent and heterogeneous in the US population , and more severe subtypes and the presence of active CD are associated with higher risk of co-morbid disorders . Future prospect i ve studies using general population sample s will further inform the nature and course of this disorder This article describes an open study of lithium carbonate in conduct-disordered children . The objective of the study was to investigate the effectiveness of lithium in reducing aggression and the usefulness of the Overt Aggression Scale ( OAS ) , as a measure of treatment effect . The subjects , 8 children , ages 9.2 to 16.9 years ( mean + /- st and ard deviation [ SD ] = 12.48 + /- 2.97 ) , were treated for 4 weeks with lithium . Optimal dosages ranged from 1200 to 1800 mg/day ( mean = 1350 + /- 227 ) with corresponding serum lithium levels ranging from 0.86 to 1.39 mEq/L ( mean = 1.05 + /- 0.17 ) . OAS results indicated that aggression decreased significantly over time . The findings from the OAS agreed with findings from a more general measure , the Global Clinical Consensus Rating , leading to the conclusion that the OAS is a promising outcome measure for treatment studies of aggression in children . Further placebo-controlled studies of lithium carbonate in reducing aggressive behavior in conduct-disordered children , employing a specific measure such as the OAS , are warranted 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 . METHODS Children hospitalized for treatment-refractory severe aggressiveness and explosiveness and with diagnosed conduct disorder were subjects in this double-blind , placebo-controlled clinical trial . After a 2-week placebo baseline period , children were r and omly assigned to lithium or placebo treatment for 6 weeks of placebo . The main outcome measures were the Global Clinical Judgments ( Consensus ) Scale , Children 's Psychiatric Rating Scale , Conners Teacher Question naire , Parent-Teacher Question naire , and the POMS . RESULTS Fifty children ( mean age 9.4 years ) completed 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 previous study . CONCLUSIONS Lithium appears to be an effective treatment for some severely aggressive children with conduct disorder . Although the POMS appeared to be reliable , it did not detect any response to lithium One of the least documented " known " effects of methylpheni date in hyperactive children is the suppression of peer aggression . In this study , 11 aggressive-hyperactive children received a low ( 0.3 mg/kg ) and moderate ( 0.6 mg/kg ) dose of methylpheni date and placebo for 2 weeks each under double-blind conditions . Children were observed in public school setting s during classroom seatwork activities , lunch , and recess . Results showed that methylpheni date suppressed nonphysical aggression ( p = 0.06 ) in the classroom , and a moderate dose decreased physical aggression ( p less than 0.01 ) and verbal aggression ( p = 0.07 ) on the playground . The effect on the rate of appropriate social interaction was variable . The majority of subjects exhibited either the same or higher levels of appropriate social interaction on the 0.6 mg/kg dose compared with placebo . In the classroom , both doses of methylpheni date also result ed in reduced levels of motor movement , off-task behavior , noncompliance , and disruptiveness . Teacher ratings of hyperactivity and conduct problem symptoms revealed drug effects , whereas parallel parent instruments did not OBJECTIVE To determine whether risperidone is effective in reducing symptoms of disruptive behaviors ( such as aggression , impulsivity , defiance of authority figures , and property destruction ) associated with conduct disorder , oppositional defiant disorder , and disruptive behavior disorder-not otherwise specified in children with subaverage IQs . METHOD The trial consisted of a 1-week , single-blind , placebo run-in period and was followed by a 6-week , double-blind , placebo-controlled period . One hundred ten children ( aged 5 - 12 years inclusive ) with an IQ of 36 - 84 with a disruptive behavior disorder and a score of at least 24 on the Conduct Problem subscale of the Nisonger Child Behavior Rating Form ( NCBRF ) were enrolled . Eighty percent of subjects had comorbid attention-deficit/hyperactivity disorder ( ADHD ) .  Risperidone doses ranged from 0.02 to 0.06 mg/kg per day . Subjects were rated on the NCBRF , Aberrant Behavior Checklist , Behavior Problems Inventory , Clinical Global Impressions ( CGI ) , modified California Verbal Learning Test ( CVLT ) , and a continuous performance task ( CPT ) . RESULTS The intention-to-treat analysis of risperidone-treated subjects showed a significant ( p < .001 ) reduction in mean scores ( from 33.4 at baseline to 17.6 at end point ; 47.3 % reduction ) versus placebo-treated subjects ( mean baseline of 32.6 to 25.8 at end point ; 20.9 % reduction ) on the Conduct Problem subscale of the NCBRF . Between-group differences in favor of risperidone were seen as early as week 1 and were significant at all post-baseline visits . Other subscales showed significant improvement with risperidone compared with placebo .  CGI scale ratings of improvement showed highly significant gains for risperidone over placebo . A sub analysis demonstrated that the effect of risperidone was unaffected by diagnosis , presence/absence of ADHD , psychostimulant use , IQ status , and somnolence .  Risperidone produced no changes on the cognitive variables ( CPT/modified CVLT ) . The most common side effects included somnolence , headache , appetite increase , and dyspepsia . Side effects related to extrapyramidal symptoms were reported in 7 ( 13.2 % ) and 3 ( 5.3 % ) of the subjects in the risperidone and placebo groups , respectively ( p = .245 ) . CONCLUSIONS Risperidone appears to be an adequately tolerated and effective treatment in children with subaverage IQs and severe disruptive behaviors such as aggression and destructive behavior Much remains to be learned about the adolescent outcomes of clinic-referred boys whose childhood conduct problems are serious enough to meet diagnostic criteria for conduct disorder ( CD ) .  Six structured diagnostic assessment s were conducted over 7 years of 73 clinic-referred 7–12-year-old boys who met criteria for CD in Wave 1 . There were substantial individual differences in the adolescent outcomes of CD , ranging from worsening to sustained recovery , with most boys showing persistent , but fluctuating levels of CD . Improvement in CD was not accounted for by treatment or incarceration , but more positive outcomes over Waves 2–7 were predicted prospect ively with substantial accuracy , using a combination of baseline predictors : less initial severity of CD , fewer symptoms of attention-deficit hyperactivity disorder , higher child verbal intelligence , greater family socioeconomic advantage , and not having antisocial biological parents Treatment-emergent symptoms and behavioral changes were assessed during an 8-week double-blind study comparing molindone and thioridazine in 31 aggressive hospitalized children ( ages 6 - 11 ) .  Molindone was found to be as effective as thioridazine in this sample . Adverse effects differed ( nonsignificantly ) for the two groups , with more sedation in the thioridazine-treated children . Clinical records from 6 adolescent in patients treated with molindone were review ed as a comparison group . Molindone is a relatively safe neuroleptic for child and adolescent in patients because of its short half-life and minimal prolonged tissue accumulation . Additional studies on different child population s are necessary before the proper indications for molindone usage in the pediatric group can be established OBJECTIVE The authors sought to replicate open-label findings showing that specific criteria for explosive temper and mood lability identify disruptive youth who improve while receiving the anticonvulsant divalproex 
    Output:
    