CRISIS AFAR:一项关于COVID-19大流行对自闭症和神经发育障碍青年心理健康和服务获取影响的国际合作研究。

IF 6.3 1区 医学 Q1 GENETICS & HEREDITY Molecular Autism Pub Date : 2023-02-14 DOI:10.1186/s13229-022-00536-z
Bethany Vibert, Patricia Segura, Louise Gallagher, Stelios Georgiades, Panagiota Pervanidou, Audrey Thurm, Lindsay Alexander, Evdokia Anagnostou, Yuta Aoki, Catherine S Birken, Somer L Bishop, Jessica Boi, Carmela Bravaccio, Helena Brentani, Paola Canevini, Alessandra Carta, Alice Charach, Antonella Costantino, Katherine T Cost, Elaine A Cravo, Jennifer Crosbie, Chiara Davico, Federica Donno, Junya Fujino, Alessandra Gabellone, Cristiane T Geyer, Tomoya Hirota, Stephen Kanne, Makiko Kawashima, Elizabeth Kelley, Hosanna Kim, Young Shin Kim, So Hyun Kim, Daphne J Korczak, Meng-Chuan Lai, Lucia Margari, Lucia Marzulli, Gabriele Masi, Luigi Mazzone, Jane McGrath, Suneeta Monga, Paola Morosini, Shinichiro Nakajima, Antonio Narzisi, Rob Nicolson, Aki Nikolaidis, Yoshihiro Noda, Kerri Nowell, Miriam Polizzi, Joana Portolese, Maria Pia Riccio, Manabu Saito, Ida Schwartz, Anish K Simhal, Martina Siracusano, Stefano Sotgiu, Jacob Stroud, Fernando Sumiya, Yoshiyuki Tachibana, Nicole Takahashi, Riina Takahashi, Hiroki Tamon, Raffaella Tancredi, Benedetto Vitiello, Alessandro Zuddas, Bennett Leventhal, Kathleen Merikangas, Michael P Milham, Adriana Di Martino
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引用次数: 2

摘要

背景:在普通人群中记录了2019冠状病毒病大流行期间的异质性心理健康结果。这种异质性尚未在患有自闭症谱系障碍(ASD)和相关神经发育障碍(NDD)的青少年中进行系统评估。为了确定大流行影响的不同模式及其在ASD/NDD青少年中的预测因素,我们重点研究了与大流行相关的症状变化和获得服务的机会。方法:采用自然观察设计,评估家长对适用于自闭症及相关神经发育状况的冠状病毒健康和影响调查倡议(CRISIS)的反应。横断面AFAR数据汇集了14个欧洲和北美地区的数据,得到了临床特征良好的样本N = 1275名ASD/NDD患者(年龄= 11.0±3.6岁;N名女性= 277)。为了确定具有不同结果的亚组,我们应用了跨11个变量的分层聚类,测量症状和获得服务的变化。然后,随机森林分类评估社会人口统计学、大流行前服务率、asd相关症状的临床严重程度以及COVID-19大流行经历/环境在预测结果亚组中的重要性。结果:聚类可分为4个亚组。一个亚组——症状仅广泛恶化(20%)——包括一系列症状恶化但服务中断与总样本的平均水平相似的年轻人。其他三个亚组在临床上相对稳定,但在服务获取方面存在差异:主要是修改服务(23%),主要是失去服务(6%),以及平均服务/症状变化(53%)。一组大流行前服务、大流行环境(如COVID-19新病例、限制)、经历(如COVID-19担忧)和年龄的不同组合预测了每个结果亚组。局限性:该研究的显著局限性是其横断面性质和重点关注大流行的前六个月。结论:同时评估大流行第一阶段症状变化和服务获取的差异,揭示了ASD/NDD青年的不同结局概况。亚组的特点是在一组与大流行有关的前期和相关经历/背景中具有不同的预测模式。研究结果可为今后危机的恢复工作和准备工作提供信息;它们还强调了国际数据共享和合作在危机时期解决最弱势群体需求方面的关键价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions.

Background: Heterogeneous mental health outcomes during the COVID-19 pandemic are documented in the general population. Such heterogeneity has not been systematically assessed in youth with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). To identify distinct patterns of the pandemic impact and their predictors in ASD/NDD youth, we focused on pandemic-related changes in symptoms and access to services.

Methods: Using a naturalistic observational design, we assessed parent responses on the Coronavirus Health and Impact Survey Initiative (CRISIS) Adapted For Autism and Related neurodevelopmental conditions (AFAR). Cross-sectional AFAR data were aggregated across 14 European and North American sites yielding a clinically well-characterized sample of N = 1275 individuals with ASD/NDD (age = 11.0 ± 3.6 years; n females = 277). To identify subgroups with differential outcomes, we applied hierarchical clustering across eleven variables measuring changes in symptoms and access to services. Then, random forest classification assessed the importance of socio-demographics, pre-pandemic service rates, clinical severity of ASD-associated symptoms, and COVID-19 pandemic experiences/environments in predicting the outcome subgroups.

Results: Clustering revealed four subgroups. One subgroup-broad symptom worsening only (20%)-included youth with worsening across a range of symptoms but with service disruptions similar to the average of the aggregate sample. The other three subgroups were, relatively, clinically stable but differed in service access: primarily modified services (23%), primarily lost services (6%), and average services/symptom changes (53%). Distinct combinations of a set of pre-pandemic services, pandemic environment (e.g., COVID-19 new cases, restrictions), experiences (e.g., COVID-19 Worries), and age predicted each outcome subgroup.

Limitations: Notable limitations of the study are its cross-sectional nature and focus on the first six months of the pandemic.

Conclusions: Concomitantly assessing variation in changes of symptoms and service access during the first phase of the pandemic revealed differential outcome profiles in ASD/NDD youth. Subgroups were characterized by distinct prediction patterns across a set of pre- and pandemic-related experiences/contexts. Results may inform recovery efforts and preparedness in future crises; they also underscore the critical value of international data-sharing and collaborations to address the needs of those most vulnerable in times of crisis.

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来源期刊
Molecular Autism
Molecular Autism GENETICS & HEREDITY-NEUROSCIENCES
CiteScore
12.10
自引率
1.60%
发文量
44
审稿时长
17 weeks
期刊介绍: Molecular Autism is a peer-reviewed, open access journal that publishes high-quality basic, translational and clinical research that has relevance to the etiology, pathobiology, or treatment of autism and related neurodevelopmental conditions. Research that includes integration across levels is encouraged. Molecular Autism publishes empirical studies, reviews, and brief communications.
期刊最新文献
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