Behavioral neuropharmacology

Abstract

Having an appreciation for neurobiologic complexity in developmentally disabled children and adolescents with behavior disorders improves our ability to treat them with drugs that have become increasingly specific in their effects. Reductionist analysis of phenotypic and genotypic disorders improves our understanding of the pathogenesis of unique patterns of adverse behaviors. Although drugs can be effective for treating specific behaviors, the cerebral mechanisms underlying these behaviors are not simple or linear in their pathways from genotype to phenotype. Our emerging knowledge about Lesch‐Nyhan disease demonstrates unexpected complexity from a single abnormal gene of purine metabolism and its diverse effects on cells, receptors, and neurotransmitters that produce characteristic self‐injurious behaviors. Several hypotheses for pathogenesis suggest ways that a defective gene might affect the developing brain and strategies for treatment. For disorders that have several abnormal genes, such as autism and bipolar disorder, biologic effects are likely to be even more complex due to gene interactions and compounded with added environmental effects, learning, and experience. There is a high incidence of comorbidity in conditions that affect behavior in children with mental retardation and developmental disabilities. Accurate diagnoses and follow‐up are essential for advanced neuropharmacology to be effective. Guidelines for the evaluation and treatment of patients who have comorbid neuropsychiatric disorders are suggested. MRDD Research Reviews 1998;4:26–35. © 1998 Wiley‐Liss, Inc.

Oiling the Brain: A Review of Randomized Controlled Trials of Omega-3 Fatty Acids in Psychopathology across the Lifespan

“…To date, fatty acid researchers have not focused specifically on the heterogeneous group of disorders that characterize mental retardation. Many people with mental retardation are likely to display co-morbid symptoms including hyperactivity, impulsivity, aggression, anxiety, and DSM-IV diagnosed psychiatric disorders such as bipolar disorder, schizophrenia [ 81 ] and ADHD [ 82 ]. It has been suggested that the high rate of psychiatric disorders in children and adolescents with mental retardation might be a major problem in their functioning and adaptation [ 83 ].…”

Victimization and depression among youth with disabilities in the US child welfare system

“…Specifically, studies have documented a linear dose-response relationship between exposure to violence and lifetime major depressive disorder (Wise et al 2001;Edwards et al 2003). However, the majority of studies of co-morbid mental illness among YWD have narrowly focused on the role of neurobiological factors and have not considered victimization and other trauma as contributing factors (Feinstein & Reiss 1996;Zimmerman et al 1998). Research on the victimization experiences and mental health of YWD in the CWS is even more limited.…”

Diagnosis and dimensional pharmacotherapy of challenging behaviour in mental retardation

“…1 Voorts wint in toenemende mate de opvatting terrein dat vroeg verworven of aangeboren hersenafwijkingen predisponeren tot functiestoornissen van het centrale zenuwstelsel met als gevolg enerzijds een reeks aspecifieke gedragsafwijkingen zoals hyperactiviteit, impulsiviteit, zelfverwonding, stemmingslabiliteit en negativisme, anderzijds psychiatrische stoornissen gelijkend op de bekende diagnostische categorieen maar dan tegelijk voorkomend. 10 Ten slotte dient te worden benadrukt dat somatische en/of neurologische afwijkingen, in het bijzonder sommige vormen van epilepsie en behandeling met somatische farmaca, anticonvulsiva en psychofarmaca gepaard kunnen gaan met gedragsafwijkingen die niet kunnen worden onderscheiden van het globale spectrum van klassieke en atypische psychiatrische syndromen. Het bovenstaande wijst op de noodzaak tot het hanteren van een gedifferentieerde psychiatrische diagnostiek waarin moeten worden betrokken de klassieke nosologische entiteiten, al dan niet met een atypische fenomenologie en eventueel in combinatie optredend, de zogenoemde behavioural phenotypes, de voor deze populatie specifieke clusters van psychopathologische en/of gedragsstoornissen en psychiatrische stoornissen geassocieerd met complexe hersenafwijkingen.…”