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1 – 4 of 4Marco Bertelli, Micaela Piva Merli, Michele Rossi, Stefano Lassi, Annamaria Bianco and Julie Colangelo
In psychiatry the concept of quality of life (QoL) has gradually acquired importance and interest, becoming a valuable outcome for many clinical trials. In pharmacological…
Abstract
Purpose
In psychiatry the concept of quality of life (QoL) has gradually acquired importance and interest, becoming a valuable outcome for many clinical trials. In pharmacological research on Autism Spectrum Disorders (ASD), most used outcome measures rely on the effect on behavioural symptoms and functioning impairment, while QoL has rarely been considered. The purpose of this paper is to provide a systematic mapping of the literature on QoL as a new outcome measure in psychopharmacological research for adults with ASD.
Design/methodology/approach
The authors reviewed the international literature on the basis of the following questions: did pharmacological interventions on ASD include QoL as an outcome measure? If yes, how and to what extent? What consideration was given to generic (whole‐person) QoL?
Findings
The literature mapping shows an extreme lack of studies including QoL as an outcome measure. The few contributions present in the literature show significant conceptual and methodological limits. The literature does not allow any comparison of effectiveness between classes of drugs or single compounds with respect to QoL.
Originality/value
The present mapping is the first contribution of literature reviewing on the application of QoL to pharmacological treatments of any kind for ASD. Although the international scientific community shows increasing interest on QoL and other person‐centred measures in psychopharmacological practice, in respect to ASD considerable research efforts are needed to make these measures applicable and their usefulness actually proved.
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Marco O. Bertelli, Michele Rossi, Roberto Keller and Stefano Lassi
The management of individuals with autism spectrum disorders (ASDs) requires a multimodal approach of behavioural, educational and pharmacological treatments. At present, there…
Abstract
Purpose
The management of individuals with autism spectrum disorders (ASDs) requires a multimodal approach of behavioural, educational and pharmacological treatments. At present, there are no available drugs to treat the core symptoms of ASDs and therefore a wide range of psychotropic medications are used in the management of problems behaviours, co-occurring psychiatric disorders and other associated features. The purpose of this paper is to map the literature on pharmacological treatment in persons with ASD in order to identify those most commonly used, choice criteria, and safety.
Design/methodology/approach
A systematic mapping of the recent literature was undertaken on the basis of the following questions: What are the most frequently used psychoactive compounds in ASD? What are the criteria guiding the choice of a specific compound? How effective and safe is every psychoactive drug used in ASD? The literature search was conducted through search engines available on Medline, Medmatrix, NHS Evidence, Web of Science and the Cochrane Library.
Findings
Many psychotropic medications have been studied in ASDs, but few have strong evidence to support their use. Most commonly prescribed medications, in order of frequency, are antipsychotics, antidepressants, anticonvulsants and stimulants, many of them without definitive studies guiding their usage. Recent animal studies can be useful models for understanding the common pathogenic pathways leading to ASDs, and have the potential to offer new biologically focused treatment options.
Originality/value
This is a practice review paper applying recent evidence from the literature.
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Marco Bertelli, Luis Salvador‐Carulla, Stefano Lassi, Michele Zappella, Raymond Ceccotto, David Palterer, Johan de Groef, Laura Benni and Paolo Rossi Prodi
Recent international experiences of community inclusion have produced a major change in residential care for people with intellectual disability (ID). Assignment and outcome…
Abstract
Purpose
Recent international experiences of community inclusion have produced a major change in residential care for people with intellectual disability (ID). Assignment and outcome assessment through new person‐centred measures are raising increasing interest; however, the information on quality of life and accommodation is still limited. This paper aims to provide an overview of the application of quality of life models and the size of the provision of different living arrangements.
Design/methodology/approach
A systematic mapping of the literature of the last decade was followed by an expert guided review of the available evidence.
Findings
QoL outcomes measures of living arrangements in people with ID show conceptual and methodological challenges. The following key topics were identified: individual level: issues related to health status, behavioural problems and other personal factors (ageing, choice and empowerment); family and peers; local level: accommodation, architecture and urbanization, and economic aspects (deprivation and costs); macro level: social participation (community inclusion). The residential solutions that are currently considered of highest efficiency are small apartments in the community and “cluster centers”.
Originality/value
The level of quality of life is very relevant in the assessment of living arrangements in people with ID although its assessment still shows significant limitations. Some accommodation typologies seem more effective than others. New conceptual models of inclusive residential care support the convenience of a wide range of accommodation alternatives that may fit the individual needs of a highly heterogeneous population group. A unique residential alternative, albeit optimal from a community care perspective, may not be adequate for all persons with ID.
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Stefano Marini, Lucia D'Agostino, Carla Ciamarra, Domenico De Berardis and Alessandro Gentile
The purpose of this case report is to report the clinical experience of the use of gabapentin in the management of problem behaviors in a person with autism spectrum disorder and…
Abstract
Purpose
The purpose of this case report is to report the clinical experience of the use of gabapentin in the management of problem behaviors in a person with autism spectrum disorder and comorbid intellectual disability. Autism spectrum disorder is a neurodevelopmental disorder with a high prevalence of intellectual disability. Challenging behaviors in autism spectrum disorder are very common. In recent years, the hypothesis that the symptoms of autism derive from a deficiency of the inhibitory neurotransmission of gamma-aminobutyric acid is gaining considerable weight.
Design/methodology/approach
Exploring behavioral symptoms improvement in an adult man with ASD and severe intellectual disability taking gabapentin.
Findings
The rating scales used show improvement in challenging behaviors and aggressions. No side effects were observed.
Originality/value
Currently, there are no authorized drugs for the treatment of the symptomatic features of autism spectrum disorder, but drugs are used for comorbid psychopathological aspects. The authors want to speculate on a hypothetical function of gabapentin in remodeling the expression of alpha-2-delta subunits in people with autism and the processing of neural information.
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