Psychiatric comorbidities increase odds of hospitalization among youth with ASD
Click Here to Manage Email Alerts
Key takeaways:
- Pediatric patients with ASD and psychiatric comorbidities had increased risk for psychiatric hospitalization.
- Early identification of psychiatric symptoms in this population may reduce symptom severity.
NEW YORK — Youth with autism spectrum disorder and psychiatric comorbidities were more likely to be hospitalized and show greater symptom severity, which led to prolonged hospital stays and higher costs, according to study results.
The results were presented in a poster at the American Psychiatric Association Annual Meeting.
“This research has clinical implications in providing a multidisciplinary approach to the care that we give to patients,” Divya Aishwarya Gandi, MBBS, recent graduate of Maharaja Sayajirao University of Baroda, told Healio. “We focused on the different comorbidities and related factors occurring in pediatric patients with autism.
“All of these factors are something that clinicians should look for when examining their patients and considering their behavior to make sure they’re not missing a diagnosis,” she added.
To evaluate the risk for psychiatric illnesses leading to hospitalization among children with ASD and to assess hospitalization outcomes, Gandi and colleagues conducted a cross-sectional study using data from the National Inpatient Sample on 467,843 pediatric psychiatric inpatients aged 6 to 18 years (mean age, 13.8 years). Among them, 2.2% (n = 10,435; 80% boys; 68.4% white) had a co-diagnosis of ASD.
Major loss of function was more prevalent among those diagnosed with vs. those without ASD (41.73% vs. 6.9%), according to the researchers.
The researchers also found that median household income appeared lower among patients diagnosed with ASD, with 28.87% of patients in the bottom 25th percentile, compared with 21.93% of patients not diagnosed with ASD.
The primary diagnosis in patients with ASD was mood disorders (59.3%), followed by impulse control disorders (15.8%) and disruptive behavior disorders (12.6%).
“I was very surprised at mood disorders being the highest related factor,” Gandi said. “From what I knew in the past, I thought anxiety disorders or maybe even ADHD would be greater than all of these other factors, so I was very surprised at the factors that did turn out to be the highest.”
Patients with ASD had a lower prevalence of suicide attempts (22.8% vs. 40.3%) and substance use (2.4% vs. 19.2%), respectively, compared with patients without ASD; however, co-diagnosis of ADHD was more prevalent in patients with ASD (39.6% vs. 25.9%).
Patients with ASD experienced significantly higher rates of major loss of bodily functioning (41.7% vs. 6.1%), longer mean hospitalization stays (9.2 days vs. 7.2 days) and increased costs ($30,152 vs. $20,886).
The researchers used a binomial logistic regression model to evaluate the odds for psychiatric hospitalization among patients with ASD.
Results showed patients with ASD and comorbid impulse control disorders had the highest likelihood of psychiatric hospitalization (OR = 7.2; 95% CI, 6.47-8.07), followed by disruptive behavior disorders (OR = 2.5; 95% CI, 2.2-2.77) and mood disorders (OR = 2.2; 95% CI, 1.99-2.41).
“Health care providers should be vigilant in recognizing psychiatric symptoms in pediatric patients with ASD,” Gandi and colleagues wrote. “Early identification of mood disorders, impulse control disorders and disruptive behavior disorders in this population can lead to interventions and potentially reduce the severity of symptoms.”