Appropriateness of psychopharmacological therapies to psychiatric diagnoses in persons with autism spectrum disorder with or without intellectual disabilities: a cross-sectional analytic study

ABSTRACT

Background

Observational studies highlighted high rates of psychotropic medication in persons with autistic spectrum disorder (ASD) with or without intellectual disability, which seems to be associated with the management of problem behaviors more than co-occurrent psychiatric disorders. The purpose of the study is to investigate psychopharmacology use and diagnoses of co-occurrent psychiatric disorder (PD) in persons with ASD attending a public mental health service in Emilia Romagna, Italy.

Methods

The present study is a multicenter, cross-sectional study.

Results

275 persons out of 486 (56.5%) resulted to receive at least one psychotropic drug, compared to 74 persons (15.2%) that were diagnosed with a PD. 63.6% were on poly-pharmacotherapy (2–10 compounds), with 37.8% receiving 3 or more medications. Antipsychotics were the most frequently prescribed class of psychotropic drugs (89%), followed by antiepileptics/mood stabilizers/lithium (42.1%) and anxiolytics (BDZ) (38.5%). Most common psychiatric disorders were psychotic disorders (29.7%), followed by anxiety disorders (17.5%), bipolar disorders (12.2%), and depressive disorders (9.4%).

Conclusions

Our findings support earlier research showing that many individuals with ASD receive pharmacotherapy without being diagnosed with a co-occurring psychiatric disorder, indicating that the main reasons for prescription and the type of compound frequently have little to no link with specific psychopathology.

KEYWORDS:

• Psychopharmacology
• psychopathology
• indication
• appropriateness
• correctness
• autism
• intellectual disability
• epilepsy

Acknowledgments

This Research was conducted as a part of Emilia-Romagna Region Autism Project.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contribution statement

Conceptualization, R.D.S. and M.O.B.; methodology, R.D.S. and M.O.B.; software, A.D.S., N.V., S. K. and A.B.; validation, R.D.S., and M.O.B.; formal analysis, S. K., N.V., A.B., and M.O.B.; investigation, R.D.S. and N.V.; resources, all authors; data curation, S. K., N.V., A.B., F.N., and M.O.B.; writing—original draft preparation, N.V. and R.D.S.; writing review and editing, M.O.B., A.B., N.V., M.C., and R.D.S.; supervision, M.O.B.; project administration, R.D.S.; All authors have read and agreed to the published version of the manuscript.

Additional information

Funding

This paper was not funded.