Li Sung-Tao, Chien Wu-Chien, Chung Chi-Hsiang, Tzeng Nian-Sheng
Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
Department of Psychiatry, Hualien Armed Forces General Hospital, Hualien, Taiwan.
Front Psychiatry. 2024 Jan 31;15:1329836. doi: 10.3389/fpsyt.2024.1329836. eCollection 2024.
Children and adolescents with autism spectrum disorder (ASD) may be particularly vulnerable to the impact of traumatic events, yet the association between ASD and the risk of developing acute stress disorder and post-traumatic stress disorder (PTSD) remains uncertain. This study aims to investigate this association, addressing the gap in large-scale evidence on the subject.
Conducted as a retrospective and matched cohort study, data was sourced from the National Health Insurance Research Database (NHIRD) in Taiwan, spanning from January 1, 2000, to December 31, 2015. The study included patients aged 18 years or under newly diagnosed with ASD (n=15,200) and compared them with a matched control group (n=45,600). The Cox proportional regression model was employed to assess the risk of acute stress disorder and PTSD.
Over the 15-year follow-up period, a total of 132 participants developed either acute stress disorder or PTSD. Among them, 105 cases (0.691% or 64.90 per 100,000 person-years) were in the ASD group, while 27 cases (0.059% or 5.38 per 100,000 person-years) were in the control group. The adjusted hazard ratio for the ASD group was significantly higher compared to the control group (25.661 with 95% CI = 15.913-41.232; P < .001).
This study provides compelling evidence that individuals with ASD face an elevated risk of developing acute stress disorder and PTSD. The findings underscore the importance of clinicians recognizing and addressing this vulnerability in ASD individuals exposed to traumatic events. This emphasizes the need for heightened attention to the risk of PTSD and acute stress disorder in the ASD population.
患有自闭症谱系障碍（ASD）的儿童和青少年可能特别容易受到创伤性事件的影响，然而，ASD与发生急性应激障碍和创伤后应激障碍（PTSD）风险之间的关联仍不明确。本研究旨在调查这种关联，填补该主题大规模证据方面的空白。
作为一项回顾性匹配队列研究进行，数据来源于台湾的国民健康保险研究数据库（NHIRD），时间跨度为2000年1月1日至2015年12月31日。该研究纳入了新诊断为ASD的18岁及以下患者（n = 15200），并将他们与一个匹配的对照组（n = 45600）进行比较。采用Cox比例回归模型评估急性应激障碍和PTSD的风险。
在15年的随访期内，共有132名参与者发生了急性应激障碍或PTSD。其中，105例（0.691%或每10万人年64.90例）在ASD组，而27例（0.059%或每10万人年5.38例）在对照组。与对照组相比，ASD组的调整后风险比显著更高（25.661，95%CI = 15.913 - 41.232；P <.001）。
本研究提供了令人信服的证据，表明患有ASD的个体发生急性应激障碍和PTSD的风险升高。研究结果强调了临床医生认识到并解决暴露于创伤性事件的ASD个体中的这种易感性的重要性。这突出了需要更加关注ASD人群中PTSD和急性应激障碍的风险。
