Citation

Yamamuro K, Tsujii N, Ota T, Kishimoto T, Iida J. Psychiatry Clin. Neurosci. 2017; 71(8): 554-561.

Affiliation

Nara Medical University Faculty of Nursing, Kashihara, Japan.

Copyright

(Copyright © 2017, John Wiley and Sons)

DOI

10.1111/pcn.12523

PMID

28317224

Abstract

AIMS: Both attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are frequently accompanied by serious aggression that requires psychiatric treatment. However, little is known about the experiences psychiatrists have had using pharmacotherapy to treat aggression in patients who have both ASD and ADHD (ASD/ADHD). The purpose of this study was to examine the experiences of Japanese child and adolescent psychiatrists in prescribing medication for aggression in patients with ASD/ADHD.

METHODS: A prospective questionnaire was mailed to 2,001 psychiatrists affiliated with the Japanese Society for Child and Adolescent Psychiatry. Multivariate logistic regression analysis was used to identify factors predicting the outcome of pharmacotherapeutic treatment of aggression in pediatric and adolescent patients with ASD/ADHD.

RESULTS: Of 2,001 psychiatrists, 571 (28.5%) completed the full questionnaire (final sample). Of these, 488 (85.4%) prescribed psychotropic medication in treating pediatric and adolescent patients with ASD/ADHD, 299 (61.3%) of them doing so to treat aggression. Prescribers' duration of practice (odds ratio [OR]: 1.055; P = 0.038) and patient symptoms of residual impulsivity (OR, 2.479; P = 0.039) increased the odds of prescribing psychotropic medications to treat aggression in these patients. The respondents reported a similar effect for patients with ADHD/ASD compared with those with ADHD only in treating aggression.

CONCLUSIONS: Japanese psychiatrists tended to prescribe psychotropic medication for aggression in pediatric and adolescent patients with ASD/ADHD. Future studies examining aggression in pediatric and adolescent patients with ASD/ADHD should aim to accumulate evidence for the use of psychotropic medications, which could help clinicians make better decisions.

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Language: en

Keywords

Attention Deficit/Hyperactivity Disorder; Autistic Spectrum Disorder; Comorbidity; Pyschopharmacoepidemiology; Questionnaires