Pharmacotherapy for the treatment of aggression in pediatric and adolescent patients with autism spectrum disorder comorbid with attention-deficit hyperactivity disorder: A questionnaire survey of 571 psychiatrists.
OBJECTIVE
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 2001 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 2001 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, 1.055; P = 0.038) and patient symptoms of residual impulsivity (odds ratio, 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.
Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan.
Kazuhiko
http://orcid.org/0000-0002-4362-3262
K
Yamamuro
Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osaka, Japan.
Noa
N
Tsujii
Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan.
Toyosaku
T
Ota
Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan.
Toshifumi
T
Kishimoto
Faculty of Nursing, Nara Medical University School of Medicine, Kashihara, Japan.
Junzo
J
Iida
D000293:Adolescent; D000374:Aggression / Q000187:drug effects*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology*; D000067877:Autism Spectrum Disorder / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D015897:Comorbidity; D006801:Humans; D007564:Japan / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011570:Psychiatry; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
D011619:Psychotropic Drugs
attention-deficit hyperactivity disorder; autism spectrum disorder; comorbidity; psychopharmacoepidemiology; questionnaires