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自闭症谱系障碍诊断后几年内精神活性药物处方的增加:一项基于人群的队列研究

Increase in Psychoactive Drug Prescriptions in the Years Following Autism Spectrum Diagnosis: A Population-Based Cohort Study.

作者信息

Croteau Caroline, Mottron Laurent, Presse Nancy, Tarride Jean-Eric, Dorais Marc, Perreault Sylvie

机构信息

Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.

Rivière des Prairies Hospital, Montreal, Quebec, Canada.

出版信息

J Popul Ther Clin Pharmacol. 2017 Aug 18;24(3):e19-e32. doi: 10.22374/1710-6222.24.3.2.

Abstract

BACKGROUND

Psychoactive medications are commonly prescribed to autistic individuals, but little is known about how their use changes after diagnosis.

OBJECTIVES

This study describes the use of psychoactive drugs in children and young adults newly diagnosed with autism spectrum, between the year before and up to 5 years after diagnosis.

METHODS

Multivariable logistic regression was used to examine the relationship between the use psychoactive drugs before the first diagnosis of autism spectrum condition (from 1998 to 2010), and the clinical and demographic characteristics, identified from public health care databases in Quebec. The types of drugs prescribed and psychoactive polypharmacy were evaluated over 5 years of follow-up. Generalized estimating equations (GEE) were used to examine the association of age and time with the use of psychoactive drugs.

RESULTS

In our cohort of 2,989 individuals, diagnosis of another psychiatric disorder before autism spectrum strongly predicted psychoactive drug use. We observed that the proportion of users of psychoactive drugs increased from 35.6% the year before, to 53.2% 5 years after the autism spectrum diagnosis. Psychoactive polypharmacy (≥2 psychoactive drug classes) also increased from 9% to 22% in that time. Age and time since diagnosis strongly associated with the types and combinations of psychoactive drugs prescribed.

CONCLUSIONS

Psychoactive drug use and polypharmacy increases substantially over time after autism spectrum disorder diagnosis in children.

摘要

背景

精神活性药物常用于自闭症患者,但对于其在诊断后的使用变化情况知之甚少。

目的

本研究描述了新诊断为自闭症谱系障碍的儿童和青年在诊断前一年至诊断后5年内精神活性药物的使用情况。

方法

采用多变量逻辑回归分析,研究1998年至2010年首次诊断自闭症谱系障碍之前精神活性药物的使用与从魁北克公共医疗数据库中识别出的临床和人口统计学特征之间的关系。在5年的随访期间评估所开药物的类型和精神活性药物联合使用情况。使用广义估计方程(GEE)研究年龄和时间与精神活性药物使用之间的关联。

结果

在我们的2989名研究对象队列中,在自闭症谱系障碍诊断之前患有其他精神疾病强烈预示着会使用精神活性药物。我们观察到,精神活性药物使用者的比例从诊断前一年的35.6%增加到自闭症谱系障碍诊断后5年的53.2%。在此期间,精神活性药物联合使用(≥2类精神活性药物)也从9%增加到22%。年龄和诊断后的时间与所开精神活性药物的类型和组合密切相关。

结论

儿童自闭症谱系障碍诊断后,精神活性药物的使用和联合使用随时间大幅增加。

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