Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
The Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, Boston, Massachusetts, USA.
J Clin Psychiatry. 2017 Nov/Dec;78(9):e1276-e1283. doi: 10.4088/JCP.16m11406.
The aim of this study was to examine the pattern of psychopharmacologic interventions in a psychiatrically referred sample of youth with autism spectrum disorder (ASD).
This retrospective chart review aimed at collecting demographic and clinical information, including data on DSM-IV-TR criteria-based psychiatric disorders and related current medication treatment and response. Data were collected in December 2011. Clinicians identified the target disorder for each medication and any adverse events. Level of psychopathology and therapeutic response was assessed by the clinician-rated Clinical Global Impressions scale (CGI).
Psychiatrically referred youth with ASD (n = 54) suffered from multiple psychopathologies (mean = 2.3) and had a marked level of morbidity (range of baseline CGI-Severity of Illness mean scores, 4.3-5.6). The most prevalent psychopathology was ADHD (83%), anxiety disorders (67%), bipolar spectrum disorder (43%), and mood disorder not otherwise specified (44%). The majority (80%) of the subjects received combination therapy (mean ± SD number of psychotropic medications = 3 ± 1.5). Forty percent of the participants responded on all treatment target symptoms (CGI-Improvement scale score ≤ 2), and an additional 10% experienced response versus nonresponse on a relatively greater number of target symptoms. Half of the subjects reported an adverse event, most commonly weight gain (28%) and sedation (12%), both from antipsychotic medication use.
Psychiatrically referred youth with ASD suffer from multiple highly impairing psychiatric disorders that require combination pharmacotherapy. These findings highlight the need for further research to guide clinical decision-making and treatment.
本研究旨在检查精神科转诊的自闭症谱系障碍（ASD）青少年人群中精神药理学干预的模式。
这是一项回顾性图表研究，旨在收集人口统计学和临床信息，包括基于 DSM-IV-TR 标准的精神障碍以及相关当前药物治疗和反应的数据。数据于 2011 年 12 月收集。临床医生确定每种药物的目标疾病以及任何不良反应。临床医生评定的临床总体印象量表（CGI）评估精神病理学程度和治疗反应。
精神科转诊的 ASD 青少年（n = 54）患有多种精神疾病（平均= 2.3），发病率高（基线 CGI-严重程度评分范围，4.3-5.6）。最常见的精神病理学是 ADHD（83%）、焦虑障碍（67%）、双相谱系障碍（43%）和未特指的心境障碍（44%）。大多数（80%）患者接受联合治疗（平均±SD 精神药物数量= 3±1.5）。40%的参与者对所有治疗目标症状均有反应（CGI-改善量表评分≤2），另外 10%的参与者在相对较多的目标症状上出现反应而非无反应。一半的受试者报告了不良反应，最常见的是体重增加（28%）和镇静（12%），两者均来自抗精神病药物的使用。
精神科转诊的 ASD 青少年患有多种严重致残的精神疾病，需要联合药物治疗。这些发现强调了需要进一步研究以指导临床决策和治疗。
