Study Quantifies Rising Autism Diagnoses and Prevalence of Psychotropic Treatment

Published June 27, 2017 | Annals of Epidemiology

In casting a wide investigative net over 15 years of data related to autism spectrum disorder (ASD) diagnoses, researchers mined an ocean of information to fill in some important missing gaps in knowledge.

For instance, no previous studies examined change in healthcare provider-coded rates of ASD over time, and few had analyzed sociodemographic factors, associated behavioral conditions, or the prevalence of psychotropic medication use. The team not only quantified the tremendous increase in ASD diagnoses from 1994 to 2009 (from 0.04 percent to 0.82 percent), but also the underlying comorbidities and family dynamics that complicate ASD care.

The related behaviors are familiar: Attention-deficit/hyperactivity disorder (ADHD), anxiety, disruptive behavior and mood disorders—all tricky emotional waters that many parents navigate every day.

“From these findings, parents should find comfort in the recognition of these comorbid behavioral diagnoses,” says Patricia Manning-Courtney, MD, Co-Director, Developmental and Behavioral Pediatrics. “This will lead to more appropriate, targeted treatment, and ultimately improved outcomes."

The team looked at data from 158,488 outpatient medical visits from the National (Hospital) Ambulatory Medical Care Surveys for children ages 2-18.

Comorbidities most often linked to psychotropic use were ADHD, mood, and anxiety disorders, and skewed toward older children. Factors disproportionately associated with diagnosis included male gender, white race, and a lack of private insurance. Future research, the team says, should address barriers to diagnosis in minority populations.

“Most of these findings weren’t too surprising, as this is what many of us see in our practices every day, and have seen over time,” Manning-Courtney says. “The disparity in diagnosis related to ethnicity is concerning, and has been for some time.”

An image showing increases in the rate of autism spectrum disorder.

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An image showing study demographics.

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A photo of Kelly Kamimura-Nishimura, MD.

Kelly Kamimura-Nishimura, MD

Patricia Manning-Courtney, MD

Citation

Kamimura-Nishimura K, Froehlich T, Chirdkiatgumchai V, Adams R, Fredstrom B, Manning P. Autism spectrum disorders and their treatment with psychotropic medications in a nationally representative outpatient sample: 1994-2009. Ann Epidemiol. 2017 Jul;27(7):448-453 e441.