Morris Arielle M, Lynch Sean, Kasdin Rachel G, Hill Isabela, Shah Salonee, Shanker Parul, Becker Timothy D, Staudenmaier Paige, Leong Alicia W, Martin Dalton, Rice Timothy
Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.
J Autism Dev Disord. 2025 May 28. doi: 10.1007/s10803-025-06898-6.
Children and adolescents with autism spectrum disorder and/or an intellectual disability (ASD/ID) are psychiatrically hospitalized at disproportionately higher rates than youth without ASD/ID. Despite this, few studies have compared the clinical courses of youth with and without ASD/ID in inpatient (IP) child and adolescent psychiatry (CAP) settings. This study used a cross-sectional design of all youth (M = 14.0 years, SD = 2.6 years) admitted to an urban IP unit between 2018 and 2021 to examine differences between ASD/ID and non-ASD/ID youth across dimensions of sociodemographic and psychiatric history and clinical course. 1101 Patients were included in the study and 170 (15.4%) had a history of ASD/ID. ASD/ID youth were more likely to be younger, be male, have histories of violence, and on average have more prior hospitalizations and existing psychotropic prescriptions than their non-ASD/ID counterparts. ASD/ID youth were less likely than their non-ASD/ID peers to be admitted for suicidality and more likely to be admitted for aggression; they had longer average lengths of stay, received more IP emergency medications for agitation, and experienced greater polypharmacy at discharge. The IP psychiatric clinical course of ASD/ID youth differs from that of non-ASD/ID youth, suggesting that ASD/ID youth often present to IP settings with externalizing symptoms. Findings highlight the importance of clinical strategies tailored to the unique needs of ASD/ID youth to improve their care in general IP CAP settings.
患有自闭症谱系障碍和/或智力残疾（ASD/ID）的儿童和青少年在精神病院住院的比例比没有ASD/ID的青少年高得多。尽管如此，很少有研究比较过在住院儿童和青少年精神病学（CAP）环境中，有无ASD/ID的青少年的临床病程。本研究采用横断面设计，对2018年至2021年间入住城市住院部的所有青少年（平均年龄M = 14.0岁，标准差SD = 2.6岁）进行研究，以检验ASD/ID青少年与非ASD/ID青少年在社会人口统计学、精神病史和临床病程等方面的差异。1101名患者纳入研究，其中170名（15.4%）有ASD/ID病史。与非ASD/ID的青少年相比，ASD/ID青少年更可能年龄更小、为男性、有暴力史，并且平均而言，他们之前住院次数更多，正在服用的精神药物也更多。与非ASD/ID的同龄人相比，ASD/ID青少年因自杀倾向入院的可能性较小，因攻击行为入院的可能性较大；他们的平均住院时间更长，因躁动接受的住院紧急药物治疗更多，出院时的联合用药情况也更严重。ASD/ID青少年的住院精神科临床病程与非ASD/ID青少年不同，这表明ASD/ID青少年在住院环境中常表现为外化症状。研究结果凸显了针对ASD/ID青少年的独特需求制定临床策略对于改善他们在一般住院CAP环境中的护理的重要性。
