Objective: 

The aim of this study was to characterize patterns of and factors associated with psychotropic medication use in children with autism spectrum disorder (ASD) receiving publicly funded mental health services.

Method: 

Data were extracted from 202 children with ASD participating in a cluster randomized trial of An Individualized Mental Health Intervention for ASD conducted in 29 publicly funded mental health programs. Children with ASD were aged 5 to 13 years (M = 9.1 years, SD = 2.4), and were 84.2% male and 59.9% Latinx. Child ASD and cognitive functioning were determined by standardized assessment. Caregivers reported child psychotropic medication use, behavior problems, ASD symptom severity, mental health symptoms, family demographics, and caregiver strain at the baseline.

Results: 

Nearly half (49.5%) of participants used psychotropic medication(s) within the past 6 months, with stimulants being most commonly reported. Child co-occurring attention-deficit/hyperactivity disorder (ADHD) (B = 1.55, p < 0.01; 95% confidence interval [CI]: 0.53–2.57), lower cognitive functioning (B = −0.03, p = 0.02; 95% CI: −0.05 to <0.00), and non-Hispanic White ethnicity (vs Hispanic/Latinx; B = 1.02, p = 02; 95% CI: −1.89 to −0.14) were associated with a greater likelihood of using any type of medication. Factors associated with medication use varied by class: stimulants—ADHD, lower ASD symptom severity, and more intensive behavior problems; SSRIs—higher ASD symptom severity; alpha-2 agonists—ADHD, higher ASD symptom severity, lower cognitive functioning, and higher caregiver strain; and antipsychotics—none.

Conclusion: 

The findings highlight factors associated with psychotropic medication use for a clinically complex population, which may inform community care improvement efforts.

中文翻译：

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公共资助的心理健康机构中自闭症儿童使用精神药物的情况

客观的： 

本研究的目的是了解接受公共资助的心理健康服务的自闭症谱系障碍 (ASD) 儿童的精神药物使用模式和相关因素。

方法： 

数据提取自 202 名患有自闭症谱系障碍 (ASD) 的儿童，他们参加了一项针对自闭症谱系障碍 (ASD) 个体化心理健康干预的整群随机试验，该试验在 29 个公共资助的心理健康项目中进行。患有 ASD 的儿童年龄为 5 至 13 岁（M = 9.1 岁，SD = 2.4），其中 84.2% 为男性，59.9% 为拉丁裔。儿童自闭症谱系障碍和认知功能通过标准化评估来确定。护理人员报告了儿童精神药物的使用情况、行为问题、自闭症谱系障碍症状严重程度、心理健康症状、家​​庭人口统计数据和护理人员的基线压力。

结果： 

近一半 (49.5%) 的参与者在过去 6 个月内使用过精神药物，其中最常报告使用兴奋剂。儿童同时发生注意力缺陷/多动障碍 (ADHD)（B = 1.55，p < 0.01；95% 置信区间 [CI]：0.53–2.57），认知功能较低（B = -0.03，p = 0.02；95% CI：-0.05 至 <0.00）和非西班牙裔白人（与西班牙裔/拉丁裔；B = 1.02，p = 02；95% CI：-1.89 至 -0.14）与使用任何类型的可能性更大相关。药物。与药物使用相关的因素因类别而异：兴奋剂——多动症、较低的自闭症症状严重程度和更严重的行为问题；SSRIs——自闭症谱系障碍症状更严重；α-2 激动剂——注意力缺陷多动症（ADHD）、自闭症谱系障碍（ASD）症状严重程度较高、认知功能较低、看护者压力较大；和抗精神病药——没有。

结论： 

研究结果强调了与临床复杂人群使用精神药物相关的因素，这可能有助于改善社区护理工作。