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      Neuropsychiatric profile and psychotropic medication use in adults with autism spectrum disorder: results from the Australian Longitudinal Study of Adults with Autism

      research-article
      Author(s): , BPsych(Hons), MBMSci, PhD, MAPS, , BA(Psych), PGDip(Psych) MA(Analytical Psych), PhD, MAPS, , BSC(OT), PhD, , MBBS, MD, FRANZCP
      Publication date (Electronic):
      Journal: BJPsych Open
      Publisher: Cambridge University Press
      Keywords: Autism spectrum disorder, psychiatric disorder, psychotropic medication, prescribing

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          Abstract

          Background

          Children and adolescents with autism spectrum disorder (ASD) are a highly medicated group. Few studies have examined the neuropsychiatric profile and patterns of psychotropic medication use among adults with ASD.

          Aims

          To describe and compare the neuropsychiatric profile and psychotropic medication use in a cohort of adults with ASD and non-autistic controls.

          Method

          Baseline data from a survey-based, longitudinal study of adults with ASD in Australia. Participants were 188 adults with ASD and 115 controls aged 25–80 years.

          Results

          ASD was associated with increased odds of psychotropic medication use even when controlling for the presence of any neurological or psychiatric disorder. There were no corresponding indications for 14.4% of psychotropic medications prescribed to adults with ASD.

          Conclusions

          This study found substantial psychotropic prescribing for adults with ASD. Patterns of psychotropic medication use may reflect prescribing for behavioural indications despite limited evidence to support this practice.

          Declaration of interest

          None.

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          Most cited references18

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          Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder.

          Fred Volkmar, Matthew Siegel, Marc Woodbury-Smith … (2014)
          Autism spectrum disorder is characterized by patterns of delay and deviance in the development of social, communicative, and cognitive skills that arise in the first years of life. Although frequently associated with intellectual disability, this condition is distinctive in its course, impact, and treatment. Autism spectrum disorder has a wide range of syndrome expression and its management presents particular challenges for clinicians. Individuals with an autism spectrum disorder can present for clinical care at any point in development. The multiple developmental and behavioral problems associated with this condition necessitate multidisciplinary care, coordination of services, and advocacy for individuals and their families. Early, sustained intervention and the use of multiple treatment modalities are indicated.
          Article 0 comments Cited 166 times – based on 0 reviews     Review now
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            The Autism-Spectrum Quotient (AQ)--adolescent version.

            Simon Baron-Cohen, Rosa Hoekstra, Rebecca Christine Knickmeyer … (2006)
            The Autism Spectrum Quotient (AQ) quantifies autistic traits in adults. This paper adapted the AQ for children (age 9.8-15.4 years). Three groups of participants were assessed: Group 1: n=52 adolescents with Asperger Syndrome (AS) or high-functioning autism (HFA); Group 2: n=79 adolescents with classic autism; and Group 3, n=50 controls. The adolescents with AS/HFA did not differ significantly from the adolescents with autism but both clinical groups scored higher than controls. Approximately 90% of the adolescents with AS/HFA and autism scored 30+, vs. none of the controls. Among the controls, boys scored higher than girls. The AQ can rapidly quantify where an adolescent is situated on the continuum from autism to normality.
            Article 0 comments Cited 152 times – based on 0 reviews     Review now
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              A longitudinal investigation of psychotropic and non-psychotropic medication use among adolescents and adults with autism spectrum disorders.

              Michael G Aman, Alicia M. Seltzer, Anna J Esbensen … (2009)
              Medication use was examined in 286 adolescents and adults with ASD over a 4.5 year period. A total of 70% were taking a psychotropic or non-psychotropic medication at the beginning of the study. Both the number of psychotropic and non-psychotropic medications taken, and the proportion of individuals taking these medications, increased significantly over the study period, with 81% taking at least one medication 4.5 years later. Our findings suggested a high likelihood of staying medicated over time. Thus, adolescents and adults with ASD are a highly and increasingly medicated population.
              Article 0 comments Cited 55 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): BJPsych Open
                Journal ID (iso-abbrev): BJPsych Open
                Journal ID (publisher-id): BJO
                Title: BJPsych Open
                Publisher: Cambridge University Press (Cambridge, UK )
                ISSN (Electronic): 2056-4724
                Publication date Collection: November 2018
                Publication date (Electronic): 13 November 2018
                Volume: 4
                Issue: 6
                Pages: 461-466
                Affiliations
                [1]Lecturer, Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Sydney , Australia
                [2]Postdoctoral Research Fellow, Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Sydney and Cooperative Research Centre for Living with Autism (Autism CRC) , Australia
                [3]Lecturer, Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Sydney and School of Health and Human Sciences, Southern Cross University , Australia
                [4]Chair, Intellectual Disability Mental Health and Head of Department, Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Sydney and Cooperative Research Centre for Living with Autism (Autism CRC) , Australia
                Author notes
                Correspondence: Professor Julian Trollor, Department of Developmental Disability Neuropsychiatry, 34 Botany Street, UNSW Sydney , NSW 2052, Australia. Email: j.trollor@ 123456unsw.edu.au
                Author information
                http://orcid.org/0000-0001-8026-2155
                Article
                Publisher Item ID: S2056472418000649 Publisher ID: 00064
                DOI: 10.1192/bjo.2018.64
                PMC ID: 6235990
                PubMed ID: 30450225
                SO-VID: 803c8a6b-e631-4e04-9d0b-46d497353b1b
                Copyright © © The Royal College of Psychiatrists 2018
                License:

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

                History
                Date received : 06 August 2018
                Date revision received : 26 September 2018
                Date accepted : 03 October 2018
                Page count
                Figures: 1, Tables: 3, References: 26, Pages: 6
                Categories
                Subject: Papers

                Keywords: autism spectrum disorder,psychiatric disorder,psychotropic medication,prescribing
                Data availability:
                Keywords: autism spectrum disorder, psychiatric disorder, psychotropic medication, prescribing

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