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高功能广泛性发育障碍:精神药物使用的发生率及模式

Higher-functioning pervasive developmental disorders: rates and patterns of psychotropic drug use.

作者信息

Martin A, Scahill L, Klin A, Volkmar F R

机构信息

Child Study Center, Yale University School of Medicine, New Haven, CT, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 1999 Jul;38(7):923-31. doi: 10.1097/00004583-199907000-00024.

Abstract

OBJECTIVE

To explore the frequency, characteristics, and associated target symptoms of psychotropic drug use among subjects with higher-functioning pervasive developmental disorders (HFPDDs).

METHOD

A total of 109 children, adolescents, and adults (mean age = 13.9 years, SD = 6.9) consecutively seeking enrollment into the Yale Child Study Center's Project on Social Learning Disabilities were included in the study. Individuals in whom Asperger's disorder, autism, or pervasive developmental disorder-not otherwise specified had been previously diagnosed and who had a documented Full Scale IQ > or = 70 completed surveys on demographic, clinical, and medication history information. To naturalistically evaluate medication use patterns in this population, each drug class was analyzed with respect to demographic and clinical variables.

RESULTS

In all, 55% of subjects were taking psychotropics, with 29.3% taking 2 or more medications simultaneously. Antidepressants were the most commonly used agents (32.1%), followed by stimulants (20.2%) and neuroleptics (16.5%). The clinical presentation of subjects taking psychotropic agents was heterogeneous, and most consistently included anxiety-related target symptoms (in 65% of medicated individuals).

CONCLUSIONS

Psychotropic medication use appears to be common among subjects with HFPDDs, yet not generally based on the results of empirical research. Clinical heterogeneity among treated subjects suggests that psychiatric comorbidity may be overlooked in this population.

摘要

目的

探讨高功能广泛性发育障碍(HFPDDs)患者使用精神药物的频率、特征及相关目标症状。

方法

共有109名儿童、青少年和成人(平均年龄=13.9岁,标准差=6.9)连续寻求加入耶鲁儿童研究中心的社会学习障碍项目,被纳入研究。之前被诊断患有阿斯伯格障碍、自闭症或未另行规定的广泛性发育障碍且记录的全量表智商≥70的个体完成了关于人口统计学、临床和用药史信息的调查。为自然地评估该人群的用药模式,对每个药物类别进行了人口统计学和临床变量分析。

结果

总体而言,55%的受试者正在服用精神药物,其中29.3%的人同时服用2种或更多药物。抗抑郁药是最常用的药物(32.1%),其次是兴奋剂(20.2%)和抗精神病药(16.5%)。服用精神药物的受试者临床表现各异,最一致的是包括与焦虑相关的目标症状(在65%的用药个体中)。

结论

在HFPDDs患者中,使用精神药物似乎很常见,但一般并非基于实证研究结果。接受治疗的受试者的临床异质性表明,该人群中精神疾病共病可能被忽视。

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