Mehl-Madrona Lewis, Leung Brenda, Kennedy Carla, Paul Sarah, Kaplan Bonnie J
Department of Psychology, Argosy University, Honolulu, Hawaii, USA.
J Child Adolesc Psychopharmacol. 2010 Apr;20(2):95-103. doi: 10.1089/cap.2009.0011.
Autism spectrum disorder (ASD) is often accompanied by self-injurious behavior (SIB), aggression, and tantrums, symptoms that have reportedly improved with micronutrient (vitamins and minerals) treatment. The current study took advantage of naturally occurring differences in parental preferences for treatment approaches. The micronutrient group asked for treatment without pharmaceuticals (n = 44, aged 2-28 years at entry [M = 8.39 +/- 5.58]). Their records were matched with those of 44 similar children whose families requested conventional treatment (medication group). Both groups improved on both the Childhood Autism Rating Scale and the Childhood Psychiatric Rating Scale (all p values <0.0001). Both groups also exhibited significant decreases in total Aberrant Behavior Checklist scores, but the micronutrient group's improvement was significantly greater (p < 0.0001). SIB Intensity was lower in the micronutrient group at the end of the study (p = 0.005), and improvement on the Clinical Global Impressions scale was greater for the micronutrient group (p = 0.0029). It is difficult to determine whether the observed changes were exerted through improvement in mood disorder or through an independent effect on autistic disorder. There were some advantages to treatment with micronutrients-lower activity level, less social withdrawal, less anger, better spontaneity with the examiner, less irritability, lower intensity SIB, markedly fewer adverse events, and less weight gain. Advantages of medication management were insurance coverage, fewer pills, and less frequent dosing.
自闭症谱系障碍（ASD）常伴有自伤行为（SIB）、攻击行为和发脾气，据报道，这些症状在接受微量营养素（维生素和矿物质）治疗后有所改善。本研究利用了父母对治疗方法的自然偏好差异。微量营养素组要求采用非药物治疗（n = 44，入组时年龄为2至28岁[M = 8.39 +/- 5.58]）。他们的记录与44名类似儿童的记录相匹配，这些儿童的家庭要求采用传统治疗（药物治疗组）。两组在儿童自闭症评定量表和儿童精神病评定量表上均有改善（所有p值<0.0001）。两组的异常行为检查表总分也均显著下降，但微量营养素组的改善更为显著（p < 0.0001）。在研究结束时，微量营养素组的自伤行为强度较低（p = 0.005），且微量营养素组在临床总体印象量表上的改善更大（p = 0.0029）。很难确定观察到的变化是通过改善情绪障碍还是通过对自闭症障碍的独立作用产生的。微量营养素治疗有一些优势——活动水平较低、社交退缩较少、愤怒较少、与检查者互动时更自然、易怒性较低、自伤行为强度较低、不良事件明显较少以及体重增加较少。药物治疗管理的优势在于保险覆盖、药片较少和给药频率较低。
