The association between co-morbid autism spectrum disorders and antipsychotic treatment failure in early-onset psychosis: a historical cohort study using electronic health records
Downs, J; Lechler, S; Dean, H; et al.Sears, N; Patel, R; Shetty, H; Simonoff, E; Hotopf, M; Ford, TJ; Covadonga, M; Arango, C; MacCabe, J; Hayes, RD; Pina-Camacho, L
Date: 1 November 2017
Article
Journal
Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press
Publisher DOI
Abstract
Objective: In a sample of children and adolescents with first-episode psychosis, we investigated whether multiple treatment failure (MTF, defined as the initiation of a third trial of novel antipsychotic due to non-adherence, adverse effects or insufficient response) was associated with co-morbid autism spectrum disorders.
Methods: ...
Objective: In a sample of children and adolescents with first-episode psychosis, we investigated whether multiple treatment failure (MTF, defined as the initiation of a third trial of novel antipsychotic due to non-adherence, adverse effects or insufficient response) was associated with co-morbid autism spectrum disorders.
Methods: Data were from the electronic health records of 638 children (51% male) with first-episode psychosis, aged between 10 and 17, referred to mental health services in South London, UK, using the Clinical Record Interactive Search (CRIS) system. The effect of autism spectrum disorder comorbidity on the development of MTF over a 5-year period was
modelled using Cox regression.
Results: There were 124 cases of MTF prior to the age of 18 (19.3% of the sample). Comorbid autism spectrum disorders was significantly associated with MTF (adjusted hazard ratio-aHR 1.99, 95% CI 1.19–3.31; p=0.008) after controlling for a range of potential confounders. Other factors significantly associated with MTF included older age at first
presentation, Black ethnicity, and frequency of clinical contact. No significant association between other co-morbid neurodevelopmental disorders (hyperkinetic disorder or intellectual disability) and MTF was found.
Conclusions: Children with first-episode psychosis and co-morbid autism spectrum disorders at first presentation are less likely to have a beneficial response to antipsychotics.
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