Weill Institute for Neurosciences, Department of Psychiatry and Behavior Sciences, University of California, San Francisco, San Francisco, California, USA.
Department of General Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Autism Res. 2021 Jul;14(7):1522-1528. doi: 10.1002/aur.2515. Epub 2021 Apr 14.
Currently available treatments for depression show limited effectiveness in adults with autism spectrum disorders (ASD) based on measures of symptom changes and clinician impressions. Perceived helpfulness is another metric that has been found to be useful for understanding treatment outcomes in the general population, but it has not yet been explored in adults with ASD. Thus, the current study collected online survey data to examine patient-perceived treatment helpfulness in a sample of 144 adults with ASD who reported that they were currently receiving community-based treatment for depression. Findings indicate that while there was variability in the levels of perceived helpfulness for both medication and individual therapy, most adults with ASD perceived treatment to be at least moderately helpful. Notably, adults with ASD reported having been in treatment for a prolonged duration (5 to 6 years). Ordinal logistic regression models showed that adults with more depressive symptoms perceived treatments to be less helpful (i.e., medications: odds ratio [OR] = 0.92, 95% confidence interval[CI] = 0.89-0.95; individual therapy: OR = 0.95, 95% CI = 0.92-0.99). Moreover, women perceived medication as more helpful than men (OR = 2.33, 95% CI = 1.13-4.82). Other individual (i.e., age, race, education level) and treatment (i.e., treatment length, concurrent treatment) characteristics were not significantly associated with perceived helpfulness. These findings suggest that future studies may want to use perceived helpfulness, in addition to traditionally used objective outcomes, to understand patients' treatment experience and evaluate depression treatments for adults with ASD. LAY SUMMARY: Adults with autism are much more likely to be depressed than those without autism; therefore, effective depression treatments are necessary to improve mental health outcomes in this group. This online survey study found that most adults with autism felt that the depression treatments they were receiving in the community (i.e., medication and individual therapy) were helpful. Females and those with fewer symptoms of depression felt treatments were more helpful compared with males and those with more symptoms of depression. Our findings suggest that when examining whether treatments for depression are effective, it may be important to measure adults' feelings about the helpfulness of the treatments in addition to measuring changes in symptoms of depression.
目前,针对自闭症谱系障碍(ASD)成人患者的抑郁症治疗方法在症状改善和临床医生印象方面的效果有限。可感知的疗效是另一种已被证明对理解普通人群治疗效果有用的指标,但尚未在 ASD 成人患者中进行探索。因此,本研究通过在线调查收集数据,在 144 名正在接受社区抑郁症治疗的 ASD 成人患者样本中,评估了患者对治疗的可感知疗效。结果表明,虽然药物治疗和个体心理治疗的可感知疗效存在差异,但大多数 ASD 成人患者认为治疗至少有一定程度的帮助。值得注意的是,这些 ASD 成人患者报告他们已经接受了长达 5 至 6 年的治疗。有序逻辑回归模型显示,抑郁症状更严重的成年人认为治疗效果较差(即药物治疗:比值比[OR] = 0.92,95%置信区间[CI] = 0.89-0.95;个体心理治疗:OR = 0.95,95% CI = 0.92-0.99)。此外,女性认为药物治疗比男性更有效(OR = 2.33,95% CI = 1.13-4.82)。其他个体(即年龄、种族、教育程度)和治疗(即治疗时间、同时治疗)特征与可感知疗效无显著相关性。这些发现表明,未来的研究可能希望除了使用传统的客观疗效指标外,还使用可感知疗效来了解患者的治疗体验并评估 ASD 成人的抑郁症治疗方法。
简而言之,自闭症成人比非自闭症成人更容易抑郁;因此,需要有效的抑郁症治疗方法来改善该群体的心理健康结果。本在线调查研究发现,大多数自闭症成人认为他们在社区中接受的抑郁症治疗(即药物治疗和个体心理治疗)是有帮助的。与男性和抑郁症状更严重的患者相比,女性和抑郁症状较轻的患者认为治疗更有效。我们的研究结果表明,在评估抑郁症治疗方法是否有效的时候,除了测量抑郁症症状的改善之外,衡量成年人对治疗效果的看法可能也很重要。