Department of Psychiatry, Seonam University College of Medicine, Myongji Hospital, Goyang, Korea.
Department of Psychiatry, Kyung Hee University Hospital, Seoul, Korea.
J Korean Med Sci. 2017 Oct;32(10):1687-1693. doi: 10.3346/jkms.2017.32.10.1687.
Children with autism are often medicated to manage emotional and behavioral symptoms; yet, data on such pharmacotherapy is insufficient. In this study, we investigated the Korean National Health Insurance Claims Database (NHICD) information related to autism incidence and psychotropic medication use. From the 2010-2012 NHICD, we selected a total of 31,919,732 subjects under 19 years old. To examine the diagnostic incidence, we selected patients who had at least one medical claim containing an 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) code for pervasive developmental disorder, F84, not diagnosed in the previous 360 days. Psychotropics were categorized into seven classes. Then, we analyzed the data to determine the mean annual diagnostic incidence and psychotropic prescription trends. Diagnostic incidence was 17,606 for the 3 years, with a mean annual incidence per 10,000 population of 5.52. Among them, 5,348 patients were prescribed psychotropics. Atypical antipsychotics were the most commonly used, followed by antidepressants. An older age, male sex, and the availability of medical aid were associated with a higher rate of prescription than observed for a younger age, female sex, and the availability of health insurance. Psychotropic drugs were used for less than one-third of patients newly diagnosed with autism, and prescription differed by sex and age. Increased diagnostic incidence is associated with an increased prescription of psychotropic drugs. Therefore, medication-related safety data and policies for psychotropic drugs in autism should be prepared.
自闭症儿童常通过药物治疗来控制情绪和行为症状,但有关此类药物治疗的数据还不够充分。在这项研究中,我们调查了与自闭症发病率和精神药物使用相关的韩国国家健康保险索赔数据库(NHICD)信息。从 2010-2012 年的 NHICD 中,我们选择了总共 31919732 名 19 岁以下的受试者。为了检查诊断发病率,我们选择了至少有一次医疗索赔包含第十次修订版国际疾病分类和相关健康问题(ICD-10)编码为广泛性发育障碍(F84)的患者,且在之前的 360 天内未被诊断出。精神药物分为七类。然后,我们分析了数据以确定平均年度诊断发病率和精神药物处方趋势。这 3 年的诊断发病率为 17606 例,每 10000 人中有 5.52 例的平均年发病率。其中,有 5348 名患者开了精神药物。非典型抗精神病药是最常用的,其次是抗抑郁药。与年龄较小、女性、有医疗保险相比,年龄较大、男性、有医疗补助与更高的处方率相关。新诊断为自闭症的患者中,不到三分之一使用了精神药物,且处方因性别和年龄而异。诊断发病率的增加与精神药物处方的增加有关。因此,应准备有关自闭症精神药物的药物相关安全性数据和政策。