Abstract :
Background: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by persistent impairments in social communication and restricted, repetitive patterns of behavior. Pharmacological treatments for the core symptoms of ASD are currently lacking, with existing medications primarily targeting associated symptoms and comorbidities such as irritability and psychiatric conditions. Early implementation of behavioral therapies has shown promise in alleviating core ASD symptoms and improving functional outcomes. Combining behavioral therapies with psychopharmacological monitoring is considered a beneficial approach.
Methodology: This cross-sectional study aimed to assess the level of knowledge regarding autism spectrum disorders among general care physicians and psychiatric physicians in a specific region. A self-reported questionnaire, comprising demographic information, understanding of autism, experience with patients with autism, and knowledge-based questions, was administered. The collected data were analyzed using Statistical Package for Social Science (SPSS) software.
Results: The study included 286 participants, with 59.1% acknowledging inadequate knowledge of autism spectrum disorders. However, 40.2% reported experience in diagnosing and collaborating with individuals with ASDs. Among the participants, 80.8% were aware of the challenges faced by children with ASDs in social interaction, communication, and behavior, while 61.9% correctly recognized the higher prevalence of ASDs in boys. The study also revealed potential adverse consequences of antipsychotic medication use in individuals with ASDs, including weight increase (67.8%), hyperprolactinemia (29.4%), extrapyramidal symptoms (32.2%), drowsiness (56.1%), and cognitive adverse effects (18.3%).
Conclusion: This study highlights a lack of knowledge among healthcare providers regarding Autism Spectrum Disorders (ASDs). This has implications for accurate diagnosis and effective treatment. The study also emphasizes the potential adverse consequences of using antipsychotic medications in individuals with ASDs. Additional education and training are needed to address these knowledge gaps and improve care for individuals with ASDs.
Keywords :
Antipsychotic Medication, Autism, autism spectrum disorderReferences :
- Hus Y, Segal O. Challenges Surrounding the Diagnosis of Autism in Children. Neuropsychiatr Dis Treat. 2021;Volume 17:3509-3529. doi:10.2147/NDT.S282569
- Narzisi A, Posada M, Barbieri F, et al. Prevalence of Autism Spectrum Disorder in a large Italian catchment area: a school-based population study within the ASDEU project. Epidemiol Psychiatr Sci. 2020;29:e5. doi:10.1017/S2045796018000483
- Zeidan J, Fombonne E, Scorah J, et al. Global prevalence of autism: A systematic review update. Autism Res. 2022;15(5):778-790. doi:10.1002/aur.2696
- Salari N, Rasoulpoor S, Rasoulpoor S, et al. The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis. Ital J Pediatr. 2022;48(1):112. doi:10.1186/s13052-022-01310-w
- Shan L, Feng J-Y, Wang T-T, Xu Z-D, Jia F-Y. Prevalence and Developmental Profiles of Autism Spectrum Disorders in Children With Global Developmental Delay. Front Psychiatry. 2022;12. doi:10.3389/fpsyt.2021.794238
- AlBatti TH, Alsaghan LB, Alsharif MF, et al. Prevalence of autism spectrum disorder among Saudi children between 2 and 4 years old in Riyadh. Asian J Psychiatr. 2022;71:103054. doi:10.1016/j.ajp.2022.103054
- Maniram J, Karrim SB, Oosthuizen F, Wiafe E. Pharmacological Management of Core Symptoms and Comorbidities of Autism Spectrum Disorder in Children and Adolescents: A Systematic Review. Neuropsychiatr Dis Treat. 2022;Volume 18:1629-1644. doi:10.2147/NDT.S371013
- Alenezi S, Alnemary F, Alamri A, Albakr D, Abualkhair L, Alnemary F. Psychotropic Medications Use among Children with Autism in Saudi Arabia. Children. 2022;9(7):966. doi:10.3390/children9070966
- De Giorgi R, De Crescenzo F, D’Alò GL, et al. Prevalence of Non-Affective Psychoses in Individuals with Autism Spectrum Disorders: A Systematic Review. J Clin Med. 2019;8(9):1304. doi:10.3390/jcm8091304
- De Crescenzo F, Postorino V, Siracusano M, et al. Autistic Symptoms in Schizophrenia Spectrum Disorders: A Systematic Review and Meta-Analysis. Front Psychiatry. 2019;10. doi:10.3389/fpsyt.2019.00078
- Psychopharmacological Approaches to a Case of Treatment-Resistant Adolescent Depression. J Can Acad Child Adolesc Psychiatry. 2022;31(4):214-221. http://www.ncbi.nlm.nih.gov/pubmed/36425018
- Liang S-C, Sun C-K, Fan H-Y, et al. Therapeutic effects of antidepressants for global improvement and subdomain symptoms of autism spectrum disorder: a systematic review and meta-analysis. J Psychiatry Neurosci. 2022;47(4):E299-E310. doi:10.1503/jpn.210191
- Deb S, Roy M, Lee R, et al. Randomized controlled trials of antidepressant and anti-anxiety medications for people with autism spectrum disorder: systematic review and meta-analysis. BJPsych Open. 2021;7(6):e179. doi:10.1192/bjo.2021.1003
- Fusar-Poli L, Brondino N, Rocchetti M, et al. Prevalence and predictors of psychotropic medication use in adolescents and adults with autism spectrum disorder in Italy: A cross-sectional study. Psychiatry Res. 2019;276:203-209. doi:10.1016/j.psychres.2019.04.013
- Al-Huseini S, Al-Barhoumi A, Al-Balushi M, et al. Effectiveness and Adverse Effects of Risperidone in Children with Autism Spectrum Disorder in a Naturalistic Clinical Setting at a University Hospital in Oman. Salloum-Asfar S, ed. Autism Res Treat. 2022;2022:1-7. doi:10.1155/2022/2313851
- Stroup TS, Gray N. Management of common adverse effects of antipsychotic medications. World Psychiatry. 2018;17(3):341-356. doi:10.1002/wps.20567
- Arbab AH, Ali NH. Awareness and Knowledge of Autism Spectrum Disorders Among Community Pharmacists in Khartoum State (Sudan), 2018. Acta Pharm Sci. 2021;59(2):291-305. doi:10.23893/1307-2080.APS.05917
- Campisi L, Imran N, Nazeer A, Skokauskas N, Azeem MW. Autism spectrum disorder. Br Med Bull. 2018;127(1):91-100. doi:10.1093/bmb/ldy026
- Wang L, Wang B, Wu C, Wang J, Sun M. Autism Spectrum Disorder: Neurodevelopmental Risk Factors, Biological Mechanism, and Precision Therapy. Int J Mol Sci. 2023;24(3):1819. doi:10.3390/ijms24031819
- Chiarotti F, Venerosi A. Epidemiology of Autism Spectrum Disorders: A Review of Worldwide Prevalence Estimates Since 2014. Brain Sci. 2020;10(5):274. doi:10.3390/brainsci10050274
- Sakai C, Mulé C, LeClair A, et al. Parent and Provider Perspectives on the Diagnosis and Management of Autism in a Chinese Immigrant Population. J Dev Behav Pediatr. 2019;40(4):257-265. doi:10.1097/DBP.0000000000000660
- Hayat AA, Meny AH, Salahuddin N, Alnemary FM, Ahuja K-R, Azeem MW. Assessment of knowledge about childhood autism spectrum disorder among healthcare workers in Makkah-Saudi Arabia. Pakistan J Med Sci. 2019;35(4). doi:10.12669/pjms.35.4.605
- Sampson W-G, Sandra AE. Comparative Study on Knowledge About Autism Spectrum Disorder Among Paediatric and Psychiatric Nurses in Public Hospitals in Kumasi, Ghana. Clin Pract Epidemiol Ment Heal. 2018;14(1):99-108. doi:10.2174/1745017901814010099
- McCormack G, Dillon AC, Healy O, Walsh C, Lydon S. Primary Care Physicians’ Knowledge of Autism and Evidence-Based Interventions for Autism: A Systematic Review. Rev J Autism Dev Disord. 2020;7(3):226-241. doi:10.1007/s40489-019-00189-4
- Altay MA. Family Physicians’ Awareness of Autism Spectrum Disorder: Results from a Survey Study. Open Access Maced J Med Sci. 2019;7(6):967-972. doi:10.3889/oamjms.2019.199
- Shawahna R. Self-rated familiarity with autism spectrum disorders among practicing nurses: a cross-sectional study in the Palestinian nursing practice. BMC Nurs. 2021;20(1):241. doi:10.1186/s12912-021-00764-3
- Shawahna R, Jaber M, Yahya N, Jawadeh F, Rawajbeh S. Are medical students in Palestine adequately trained to care for individuals with autism spectrum disorders? A multicenter cross-sectional study of their familiarity, knowledge, confidence, and willingness to learn. BMC Med Educ. 2021;21(1):424. doi:10.1186/s12909-021-02865-8
- Shawahna R, Fahed B, Qadri D, Sharawi L, Soroghli M, Dweik M. Awareness and Knowledge of Autism Spectrum Disorders Among Pharmacists: A Cross-Sectional Study in Palestinian Pharmacy Practice. J Autism Dev Disord. 2017;47(6):1618-1627. doi:10.1007/s10803-017-3085-5
- DeFilippis M, Wagner KD. Treatment of Autism Spectrum Disorder in Children and Adolescents. Psychopharmacol Bull. 2016;46(2):18-41. http://www.ncbi.nlm.nih.gov/pubmed/27738378
- Erickson C, Srivorakiat L, Wink L, Pedapati E, Fitzpatrick S. Aggression in autism spectrum disorder: presentation and treatment options. Neuropsychiatr Dis Treat. Published online June 2016:1525. doi:10.2147/NDT.S84585
- Loy JH, Merry SN, Hetrick SE, Stasiak K. Atypical antipsychotics for disruptive behavior disorders in children and youths. Cochrane Database Syst Rev. 2017;2017(8). doi:10.1002/14651858.CD008559.pub3
- Hong M, Lee SY, Han J, et al. Prescription Trends of Psychotropics in Children and Adolescents with Autism Based on Nationwide Health Insurance Data. J Korean Med Sci. 2017;32(10):1687. doi:10.3346/jkms.2017.32.10.1687
- Spencer D, Marshall J, Post B, et al. Psychotropic Medication Use and Polypharmacy in Children With Autism Spectrum Disorders. Pediatrics. 2013;132(5):833-840. doi:10.1542/peds.2012-3774
- Aishworiya R, Valica T, Hagerman R, Restrepo B. An Update on Psychopharmacological Treatment of Autism Spectrum Disorder. Neurotherapeutics. 2022;19(1):248-262. doi:10.1007/s13311-022-01183-1
- Schein J, Childress A, Adams J, et al. Treatment patterns among children and adolescents with attention-deficit/hyperactivity disorder in the United States – a retrospective claims analysis. BMC Psychiatry. 2022;22(1):555. doi:10.1186/s12888-022-04188-4
- Libowitz MR, Nurmi EL. The Burden of Antipsychotic-Induced Weight Gain and Metabolic Syndrome in Children. Front Psychiatry. 2021;12. doi:10.3389/fpsyt.2021.623681
- Pillinger T, McCutcheon RA, Vano L, et al. Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis. The Lancet Psychiatry. 2020;7(1):64-77. doi:10.1016/S2215-0366(19)30416-X
- Dhaliwal KK, Orsso CE, Richard C, Haqq AM, Zwaigenbaum L. Risk Factors for Unhealthy Weight Gain and Obesity among Children with Autism Spectrum Disorder. Int J Mol Sci. 2019;20(13):3285. doi:10.3390/ijms20133285
- Walls M, Broder-Fingert S, Feinberg E, Drainoni M-L, Bair-Merritt M. Prevention and Management of Obesity in Children with Autism Spectrum Disorder Among Primary Care Pediatricians. J Autism Dev Disord. 2018;48(7):2408-2417. doi:10.1007/s10803-018-3494-0
- Lu Z, Sun Y, Zhang Y, et al. Pharmacological treatment strategies for antipsychotic-induced hyperprolactinemia: a systematic review and network meta-analysis. Transl Psychiatry. 2022;12(1):267. doi:10.1038/s41398-022-02027-4
- Stojkovic M, Radmanovic B, Jovanovic M, Janjic V, Muric N, Ristic DI. Risperidone Induced Hyperprolactinemia: From Basic to Clinical Studies. Front Psychiatry. 2022;13. doi:10.3389/fpsyt.2022.874705
- Musco S, Ruekert L, Myers J, Anderson D, Welling M, Cunningham EA. Characteristics of Patients Experiencing Extrapyramidal Symptoms or Other Movement Disorders Related to Dopamine Receptor Blocking Agent Therapy. J Clin Psychopharmacol. 2019;39(4):336-343. doi:10.1097/JCP.0000000000001061