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EPA-1395 – Psychopathological Predictors of Antipsychotic Medication Use in Childhood Autism Spectrum Disorders

Published online by Cambridge University Press:  15 April 2020

J. Downs
Affiliation:
Psychological Medicine, King's College London, London, United Kingdom
M. Hotopf
Affiliation:
Psychological Medicine, King's College London, London, United Kingdom
R.G. Jackson
Affiliation:
Psychological Medicine, King's College London, London, United Kingdom
H. Shetty
Affiliation:
BRC Nucleus, South London and Maudsley NHS Foundation Trust, London, United Kingdom
T. Ford
Affiliation:
Institute of Health Services Research, University of Exeter Medical School, Exeter, United Kingdom
R. Stewart
Affiliation:
Psychological Medicine, King's College London, London, United Kingdom
R.D. Hayes
Affiliation:
Psychological Medicine, King's College London, London, United Kingdom

Abstract

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Introduction

Autism Spectrum Disorders (ASDs) affect 1% of children and are associated with lifelong psychosocial impairments. The majority of children with ASD will experience co-occurring psychiatric disorders. In the UK, antipsychotics remain unlicensed for use in ASDs, however 10% of children with ASD receive antipsychotic treatment; the co-occurring disorders being targeted by these medications remains unclear.

Objectives

To examine rates of antipsychotic medication use and identify associated co-occurring disorders among children with ASD receiving psychiatric care.

Methods

The sample consisted of 2844 children aged 2 to 17 with a NHS clinician recorded ICD-10 diagnoses for ASD between 2008–2013. Clinical variables extracted from their anonymised electronic patient records included disorder severity, medication use, co-occurring ICD-10 diagnoses, family characteristics, demographics and antipsychotic use.

Results

Of the 2844 children (79% male), the majority (57%) had co-occurring psychiatric diagnoses. 313 (11%) received antipsychotic medication. The proportion of children aged 13 to 17 years and 6 to 12 years prescribed antipsychotics was 19% and 7% respectively. After controlling for socio-demographic factors, disorder severity, specialist treatment, inpatient duration, risk of self harm, violence to others, self injurious behaviour, maltreatment history, parental mental illness, caregiver anxiety, and neighbourhood deprivation, multivariate regression analysis revealed only hyperactivity disorders (O.R 1.94, 95%C.I. 1.32–2.86), psychotic disorders (O.R 5.12 95% C.I. 2.6–10.1), mood disorders (O.R 2.02, 95%C.I. 1.04–3.92) and intellectual disability (O.R 2.89 95% C.I. 1.89–4.71) were associated with anti-psychotic use.

Conclusions

The prescription of antipsychotic medications in this UK ASD clinical sample is strongly associated with specific co-occurring psychiatric disorders and intellectual disability.

Type
FC04 - Free Communications Session 04: Child and Adolescent Psychiatry
Copyright
Copyright © European Psychiatric Association 2014
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