Mellahn Olivia J, Knott Rachael, Tiego Jeggan, Kallady Kathryn, Williams Katrina, Bellgrove Mark A, Johnson Beth P
Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.
Department of Paediatrics, Paediatrics Education & Research, Monash University, Melbourne, VIC, Australia.
Front Psychiatry. 2022 Jun 27;13:914668. doi: 10.3389/fpsyt.2022.914668. eCollection 2022.
Attention deficit hyperactivity disorder (ADHD) frequently co-occurs with other neurodevelopmental diagnoses, such as autism spectrum disorder (autism), which can make clinical decision making around symptom management challenging for clinicians. There is a paucity of research examining pharmacotherapeutic management of children who have ADHD with co-occurring diagnoses. We aimed to report on the co-occurring diagnoses and symptom profile of children, and report on medication use, stratified by ADHD, autism and ADHD + autism diagnoses.
Caregivers of 505 children (2-18 years) with ADHD ( = 239), autism ( = 117), and co-occurring ADHD + autism ( = 149) completed a questionnaire on current medication use and clinical rating scales about their child's symptoms, as part of a broader project investigating diagnosis and management of symptoms in children with ADHD or autism.
The parents of the ADHD group reported a higher proportion of their children had learning disorders (17.15%) and speech and language disorders (4.60%) compared to the parents of the autism and ADHD + autism groups. Parents of the ADHD + autism group reported higher proportions of intellectual disability (5.37%), oppositional defiant disorder (20.13%), anxiety (38.93%), depression (6.71%) and genetic conditions (3.36%) in their children, in comparison to the parents of the ADHD and autism groups. Children with ADHD were reported to be taking a higher proportion of psychotropic medication (90%), followed by ADHD + autism (86%) and autism (39%). The parents of children with ADHD + autism reported a higher proportion of non-stimulant ADHD medication (25.5%), antipsychotic (18.79%), antidepressant (22.15%) and melatonin (31.54%) use by their children, compared to the parents of the ADHD and autism groups.
A similar proportion of children with ADHD + autism and ADHD were reported to be taking medication. However, the types of medication taken were different, as expected with reported co-occurring diagnoses. The complexity of symptoms and diagnoses in ADHD + autism warrants targeted research to optimize management and therapeutic outcomes.
注意缺陷多动障碍（ADHD）常与其他神经发育性诊断同时出现，如孤独症谱系障碍（自闭症），这可能使临床医生在围绕症状管理进行临床决策时面临挑战。关于患有ADHD并伴有其他诊断的儿童的药物治疗管理的研究很少。我们旨在报告儿童的共病诊断和症状概况，并报告按ADHD、自闭症和ADHD+自闭症诊断分层的药物使用情况。
作为一项调查ADHD或自闭症儿童症状诊断和管理的更广泛项目的一部分，505名2至18岁患有ADHD（n = 239）、自闭症（n = 117）以及ADHD合并自闭症（n = 149）的儿童的照顾者完成了一份关于当前药物使用情况的问卷以及关于其孩子症状的临床评定量表。
与自闭症组和ADHD+自闭症组的家长相比，ADHD组的家长报告他们的孩子患有学习障碍（17.15%）和言语语言障碍（4.60%）的比例更高。与ADHD组和自闭症组的家长相比，ADHD+自闭症组的家长报告他们的孩子患有智力残疾（5.37%）、对立违抗障碍（20.13%）、焦虑症（38.93%）、抑郁症（6.71%）和遗传性疾病（3.36%）的比例更高。据报告，患有ADHD的儿童服用精神药物的比例更高（90%），其次是ADHD+自闭症（86%）和自闭症（39%）。与ADHD组和自闭症组的家长相比，ADHD+自闭症儿童的家长报告他们的孩子使用非刺激性ADHD药物（25.5%）、抗精神病药物（18.79%）、抗抑郁药物（22.15%）和褪黑素（31.54%）的比例更高。
据报告，患有ADHD+自闭症和ADHD的儿童服用药物的比例相似。然而，正如所报告的共病诊断所预期的那样，所服用药物的类型不同。ADHD+自闭症中症状和诊断的复杂性需要有针对性的研究，以优化管理和治疗效果。
