J Korean Med Sci.  2017 Oct;32(10):1687-1693. 10.3346/jkms.2017.32.10.1687.

Prescription Trends of Psychotropics in Children and Adolescents with Autism Based on Nationwide Health Insurance Data

• Hong M
• Lee SY
• Han J
• Park JC
• Lee YJ
• Hwangbo R
• Chang H
• Cho SW
• Bhang SY
• Kim B
• Hwang JW
• Bahn GH

• KMID: 2400443
• DOI: http://doi.org/10.3346/jkms.2017.32.10.1687

Abstract

Children with autism are often medicated to manage emotional and behavioral symptoms; yet, data on such pharmacotherapy is insufficient. In this study, we investigated the Korean National Health Insurance Claims Database (NHICD) information related to autism incidence and psychotropic medication use. From the 2010-2012 NHICD, we selected a total of 31,919,732 subjects under 19 years old. To examine the diagnostic incidence, we selected patients who had at least one medical claim containing an 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) code for pervasive developmental disorder, F84, not diagnosed in the previous 360 days. Psychotropics were categorized into seven classes. Then, we analyzed the data to determine the mean annual diagnostic incidence and psychotropic prescription trends. Diagnostic incidence was 17,606 for the 3 years, with a mean annual incidence per 10,000 population of 5.52. Among them, 5,348 patients were prescribed psychotropics. Atypical antipsychotics were the most commonly used, followed by antidepressants. An older age, male sex, and the availability of medical aid were associated with a higher rate of prescription than observed for a younger age, female sex, and the availability of health insurance. Psychotropic drugs were used for less than one-third of patients newly diagnosed with autism, and prescription differed by sex and age. Increased diagnostic incidence is associated with an increased prescription of psychotropic drugs. Therefore, medication-related safety data and policies for psychotropic drugs in autism should be prepared.

Keyword

Adolescent; Antipsychotic Agents; Autistic Spectrum Disorder; Central Nervous System Stimulants; Child; Drug Utilization; Incidence

MeSH Terms

Adolescent*
Antidepressive Agents
Antipsychotic Agents
Autistic Disorder*
Behavioral Symptoms
Central Nervous System Stimulants
Child*
Drug Therapy
Drug Utilization
Female
Humans
Incidence
Insurance, Health*
International Classification of Diseases
Male
National Health Programs
Prescriptions*
Psychotropic Drugs
Antidepressive Agents
Antipsychotic Agents
Central Nervous System Stimulants
Psychotropic Drugs

Figure

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  Fig. 1 Percentage distribution of psychotropic drugs by age group. AP = antipsychotics, AD = antidepressants, AA = anti-Attention-Deficit/Hyperactivity Disorder (ADHD) drugs, MS = mood stabilizers, Anx = anxiolytics, OA = opioid antagonists, Misc = miscellaneous.

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