Department of Psychiatry, Penn State College of Medicine, Hershey Medical Center, 500 University Dr., Hershey, PA, United States.
Department of Psychiatry, Penn State College of Medicine, Hershey Medical Center, 500 University Dr., Hershey, PA, United States.
Psychiatry Res. 2020 Jun;288:112937. doi: 10.1016/j.psychres.2020.112937. Epub 2020 Apr 9.
Most children with autism have ADHD, and children with ADHD-Combined and children with autism have high rates of irritable, oppositional, and aggressive behavior. Despite similar symptoms, prescribing practices may differ between autism and ADHD, which has not been examined in a single study. 1407 children with autism and 1036 with ADHD without autism, 2-17 years, were compared with 186 typical peers. Symptom scores were maternal Pediatric Behavior Scale ratings in eight areas (ADHD, oppositional/aggressive, irritable/angry, anxious, depressed, and social, writing, and learning problems). Psychotropics were prescribed to 38.0% with ADHD-Combined, 33.3% with autism, and 20.2% with ADHD-Inattentive, most often an ADHD medication (22.1% stimulant, 2.3% atomoxetine), antipsychotic (7.8%), SSRI (5.5%), and alpha agonist (4.9%). ADHD medications were more often prescribed than other medications in all diagnostic groups. Compared to autism, children with ADHD-Combined were more likely to be prescribed an ADHD medication, whereas antipsychotics and SSRIs were more likely to be prescribed in autism than in ADHD-Combined. Children with ADHD-Inattentive were least impaired and least likely to be medicated. More severely impaired children were more often medicated regardless of diagnosis. Symptom scores were far worse for treated and untreated children with ADHD and with autism than for typical peers.
大多数自闭症儿童同时患有 ADHD，而 ADHD 混合型和自闭症儿童则具有较高的易怒、对立和攻击性行为发生率。尽管症状相似，但自闭症和 ADHD 的处方实践可能存在差异，而这尚未在单一研究中进行过检验。研究比较了 1407 名自闭症儿童和 1036 名无自闭症的 ADHD 儿童（年龄 2-17 岁）以及 186 名典型同龄人。症状评分来自母亲对八个领域的儿科行为量表评定（ADHD、对立/攻击、易怒/愤怒、焦虑、抑郁、社交、书写和学习问题）。38.0%的 ADHD 混合型、33.3%的自闭症和 20.2%的 ADHD 注意力不集中型儿童被开具了精神药物，最常见的是 ADHD 药物（22.1%为兴奋剂，2.3%为托莫西汀）、抗精神病药（7.8%）、SSRIs（5.5%）和α激动剂（4.9%）。在所有诊断组中，ADHD 药物的处方频率均高于其他药物。与自闭症相比，ADHD 混合型儿童更有可能被开具 ADHD 药物，而抗精神病药和 SSRIs 在自闭症中比在 ADHD 混合型中更有可能被开具。ADHD 注意力不集中型儿童的受损程度最低，最不可能接受药物治疗。受损程度越严重的儿童，无论诊断如何，越有可能接受药物治疗。与典型同龄人相比，接受治疗和未接受治疗的 ADHD 儿童和自闭症儿童的症状评分要差得多。
