Geoffray Marie-Maude, Baltazar Matias, Michelon Cécile, Jurek Lucie, Baghdadli Amaria
Centre Hospitalier Le Vinatier, Bron, France.
Université Claude Bernard Lyon 1, Lyon, Rhône-Alpes, France.
Front Psychiatry. 2023 Jul 21;14:1153543. doi: 10.3389/fpsyt.2023.1153543. eCollection 2023.
Psychotropic drugs are often used to treat behavior problems in ASD with some evidence supporting efficacity (e.g.: risperidone and irritability) but also significant side effects at the short and longer-term. It is then essential to know better the factors associated with the prescription of these medications and potentially implement early behavioral and psychosocial intervention or cognitive remediation before to use medication. We designed a case-control study based on the population of the ELENA cohort to assess the factors associated with early psychotropic drugs use in children with ASD. Externalized behavior symptoms (measured by the Child Behavior Checklist) is the leading risk factor during the first years of follow-up (aOR = 2.8; CI [1.04; 7.67]; = 0.04). Age, gender, autism severity, adaptive behaviors, or internalized behaviors were not associated with psychotropic medication prescription. Low IQ and parents who had received training tended to increase the risk of psychotropic medication prescription during follow-up but were not statistically significant. These findings underscore the need for early identification of symptoms of externalizing behaviour, early appropriate information for parents about treatment with and without medication, early analysis of externalising behaviour and targeted treatments.
精神药物常用于治疗自闭症谱系障碍（ASD）中的行为问题，有一些证据支持其有效性（例如：利培酮与易怒），但在短期和长期也有显著的副作用。因此，必须更好地了解与这些药物处方相关的因素，并在用药前可能实施早期行为和心理社会干预或认知矫正。我们基于ELENA队列人群设计了一项病例对照研究，以评估与ASD儿童早期使用精神药物相关的因素。外化行为症状（通过儿童行为量表测量）是随访最初几年的主要危险因素（调整后比值比=2.8；可信区间[1.04；7.67]；P=0.04）。年龄、性别、自闭症严重程度、适应性行为或内化行为与精神药物处方无关。低智商以及接受过培训的父母在随访期间有增加精神药物处方的风险，但无统计学意义。这些发现强调了早期识别外化行为症状、为父母提供有关用药和不用药治疗的早期适当信息、对外化行为进行早期分析以及进行有针对性治疗的必要性。
