Patterns of current psychotropic medication use among 5,181 children with autism spectrum disorders (ASD) enrolled in a Web-based registry were examined. Overall, 35% used at least one psychotropic medication, most commonly stimulants, neuroleptics, and/or antidepressants. Those who were uninsured or exclusively privately insured were less likely to use >or=3 medications than were those insured by Medicaid. Psychiatrists and neurologists prescribed the majority of psychotropic medications. In multivariate analysis, older age, presence of intellectual disability or psychiatric comorbidity, and residing in a poorer county or in the South or Midwest regions of the United States increased the odds of psychotropic medication use. Factors external to clinical presentation likely affect odds of psychotropic medication use among children with ASD.
"Similarly, Oswald and Sonenklar reported 83% of autistics had at least one drug claim during one year . While in a recent study investigating the patterns of psychotropic medication use among 5,181 children with autism in USA, Rosenberg and colleagues reported that 35% used at least one psychotropic medication, most commonly stimulants, neuroleptics, and/or antidepressants . The majority of psychotropic medications were prescribed for older age, or in the presence of intellectual disability or psychiatric comorbidity, and when the patient resided in a poorer county . "
[Show abstract][Hide abstract] ABSTRACT: Autism is a biological disorder with clearly defined phenomenology. Studies from the Middle East on this topic have been particularly rare. Little is known about the influence of culture on clinical features, presentations and management of autism. The current study was done to compare characteristics of autism in two groups of Egyptian as well as Saudi children.
The sample included 48 children with Autism Spectrum Disorder. They were recruited from the Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt and Al-Amal Complex for Mental Health, Dammam, Kingdom of Saudi Arabia. They were grouped into an Egyptian group (n = 20) and a Saudi group (n = 28). They were assessed both clinically and psychometrically using the GARS, the Vineland adaptive behavioral scale, and the Stanford Binnet IQ test.
Typical autism was more prevalent than atypical autism in both groups. There were no statistically significant differences in clinical variables like regression, hyperactivity, epilepsy or mental retardation. Delayed language development was significantly higher in the Egyptian group while delay in all developmental milestones was more significant in the Saudi group. The Vineland communication subscale showed more significant severe and profound communication defects in the Saudi group while the Gilliam developmental subscale showed significantly more average scores in the Egyptian group. Both groups differed significantly such that the age of noticing abnormality was younger in the Saudi group. The age at diagnosis and at the commencement of intervention was lower in the Egyptian group. The Saudi group showed a higher percentage of missing examinations, older birth order and significantly higher preference to drug treatment, while the Egyptian group showed a high preference to behavioral and phoniatric therapies, higher paternal and maternal education, higher employment among parents and higher family concern.
Cultural context may significantly influence the age of noticing abnormality, the age of starting intervention, developmental and perinatal problems, family concerns about managing the problem as well as familial tendency for neurodevelopmental disorders, all of which have important impact on clinical symptomatology and severity of autism. Culture also influences significantly the ways of investigating and treating autism.
Child and Adolescent Psychiatry and Mental Health 11/2011; 5(1):34. DOI:10.1186/1753-2000-5-34
[Show abstract][Hide abstract] ABSTRACT: In this paper it is shown that if an input-output discrete-time model is available, feedback linearization can be easily accomplished without the use of geometric differential tools and without the need for measurements of all states or state observers. Feedback linearization is sub-sequently combined with internal model controller design to obtain a nonlinear controller that can stabilize unstable steady states, follow setpoint changes and reject disturbances. Global stability is proved in the absence of plant/model mismatch and zero steady-state offset is guaranteed if the closed loop system is stable, even for inaccurate models. Subsequently, the above controller is used to develop a nonlinear adaptive controller. The effectiveness of the adaptive controller is demonstrated by application to a highly nonlinear simulated continuous stirred-tank reactor.
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