Evidence map›Paper›PMID 26472118›Full record

ArticleEuropean child & adolescent psychiatry2016

Clinical predictors of antipsychotic use in children and adolescents with autism spectrum disorders: a historical open cohort study using electronic health records.

Johnny Downs, Matthew Hotopf, Tamsin Ford, Emily Simonoff, Richard G Jackson, Hitesh Shetty, Robert Stewart, Richard D Hayes

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European child & adolescent psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 3 pooled it
1.6field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
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  6. Article
  7. Stressful life events in electronic health records: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2024
    Article
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  19. Investigating Bullying as a Predictor of Suicidality in a Clinical Sample of Adolescents with Autism Spectrum Disorder.Autism research : official journal of the International Society for Autism Research · 2020
    Article
  20. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Johnny DownsInstitute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box 63, SE5 8AF, London, UK. johnny.downs@kcl.ac.uk.
Matthew HotopfInstitute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box 63, SE5 8AF, London, UK.
Tamsin FordInstitute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box 63, SE5 8AF, London, UK.
Emily SimonoffInstitute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box 63, SE5 8AF, London, UK.
Richard G JacksonInstitute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box 63, SE5 8AF, London, UK.
Hitesh ShettySouth London and Maudsley NHS Foundation Trust, London, UK.
Robert StewartInstitute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box 63, SE5 8AF, London, UK.
Richard D HayesInstitute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box 63, SE5 8AF, London, UK.
King's College London · GBSouth London and Maudsley NHS Foundation Trust · GB

Funding

Medical Research Council MR/J01219X/1Medical Research Council MR/L017105/1
6 · The paper itself

Abstract

Children with autism spectrum disorders (ASD) are more likely to receive antipsychotics than any other psychopharmacological medication, yet the psychiatric disorders and symptoms associated with treatment are unclear. We aimed to determine the predictors of antipsychotic use in children with ASD receiving psychiatric care. The sample consisted of 3482 children aged 3-17 with an ICD-10 diagnosis of ASD referred to mental health services between 2008 and 2013. Antipsychotic use outcome, comorbid diagnoses, and other clinical covariates, including challenging behaviours were extracted from anonymised patient records. Of the 3482 children (79 % male) with ASD, 348 (10 %) received antipsychotic medication. The fully adjusted model indicated that comorbid diagnoses including hyperkinetic (OR 1.44, 95 %CI 1.01-2.06), psychotic (5.71, 3.3-10.6), depressive (2.36, 1.37-4.09), obsessive-compulsive (2.31, 1.16-4.61) and tic disorders (2.76, 1.09-6.95) were associated with antipsychotic use. In addition, clinician-rated levels of aggression, self-injurious behaviours, reduced adaptive function, and overall parental concern for their child's presenting symptoms were significant risk factors for later antipsychotic use. In ASD, a number of comorbid psychiatric disorders are independent predictors for antipsychotic treatment, even after adjustment for familial, socio-demographic and individual factors. As current trial evidence excludes children with comorbidity, more pragmatic randomised controlled trials with long-term drug monitoring are needed.

Indexed as

Electronic Health RecordsAdolescentAntipsychotic AgentsAutism Spectrum DisorderChildCohort StudiesFemaleHumansMalePredictive Value of TestsSelf-Injurious BehaviorTic DisordersAntipsychotic AgentsAntipsychotic medicationsAutism spectrum disordersChallenging behavioursChild and adolescencePsychiatric comorbidity

Identifiers

PMID26472118
PMCPMC4889626
OpenAlexW2177937747

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.