Vasa Roma A, Mazurek Micah O
aKennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland bDepartment of Health Psychology, Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columba, Missouri, USA.
Curr Opin Psychiatry. 2015 Mar;28(2):83-90. doi: 10.1097/YCO.0000000000000133.
Anxiety is one of the most common co-occurring psychiatric conditions in youth with autism spectrum disorders (ASDs). This article reviews recent evidence as well as earlier relevant studies regarding the characteristics, assessment, and treatment of anxiety in youth with ASD.
It is well established that the prevalence of anxiety in youth with an ASD is significantly greater than the prevalence of anxiety in the general population. Recent studies have highlighted the importance of informant, method, and instrument when measuring anxiety in this population. Despite the high prevalence, findings to date have been unable to identify any consistent risk factors for anxiety. New psychological treatments, including modified cognitive behavioral therapy for youth with high functioning ASD and co-occurring anxiety, are emerging. Pharmacological data, however, are scant. Existing studies show that youth with ASD are at increased risk for behavioral activation when taking SSRIs.
Clinicians working with youth with ASD are encouraged to routinely screen for anxiety. Until further data are available, clinical judgment is needed when prescribing treatments, particularly selective serotonin reuptake inhibitors, which require close monitoring of side-effects. Research on risk factors, pathophysiology, and treatment of this condition is needed.
焦虑是自闭症谱系障碍（ASD）青少年中最常见的共病精神疾病之一。本文综述了有关ASD青少年焦虑症的特征、评估和治疗的最新证据以及早期相关研究。
现已明确，患有ASD的青少年中焦虑症的患病率显著高于普通人群中的焦虑症患病率。最近的研究强调了在该人群中测量焦虑时信息提供者、方法和工具的重要性。尽管患病率很高，但迄今为止的研究结果尚未能确定任何一致的焦虑风险因素。新的心理治疗方法正在出现，包括针对高功能ASD和共病焦虑症青少年的改良认知行为疗法。然而，药理学数据很少。现有研究表明，患有ASD的青少年在服用选择性5-羟色胺再摄取抑制剂（SSRI）时行为激活风险增加。
鼓励为患有ASD的青少年提供临床服务的医生常规筛查焦虑症。在获得更多数据之前，开药治疗时需要临床判断，尤其是选择性5-羟色胺再摄取抑制剂，需要密切监测副作用。需要对这种疾病的风险因素、病理生理学和治疗进行研究。
