Psychiatric Orders in Psychoanalytic Treatment of ASD

Study Overview
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Brief Summary
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Autism Spectrum Disorder (ASD) is often accompanied by a variety of other symptoms, such as bipolar disorder, Attention Deficit Hyperactivity Disorder (ADHD), Social Anxiety Disorder (SAD), Avoidant Personality Disorder (AvPD), Obsessive Compulsive Disorder (OCD), etc. The behavioral and social complications often marginalize the population, impact on life satisfaction, undermined societal values that impact on economic and financial fairness, and so forth. Furthermore, persons with ASD are neurodiverse from standardized pharmacological and clinical cares, and are interpreted disadvantaged in the context of neurotypical treatments. The research protocol aims to differentiate the neuropharmacological implications of ASD from its behavioral and social implications. Such a differentiation is beneficial to the quality of care for neurodiverse population, both in terms of precision treatment in medical settings, and in terms of psychotherapeutic treatment efficacy in the interpretation of behavioral and social traits. The study protocol continues from the adverse event of the participant in NCT05711810 trial, after the positive immunological results in the NCT05839236 trial. The intervention medicine continues from Sertraline adjusted on the choice of Selective Serotonin Reuptake Inhibitor (SSRI) in the previous two trials for complex post-traumatic stress disorder (CPTSD) of the participant, and its combined used with Duloxetine in the choice of Selective Norephedrine Reuptake Inhibitor (SNRI) for norephedrine regulations. The hypothesized target is on the discrete psychiatric intervention centered approach to ASD treatment care. In the PRC where the study is being carried out, amphetamine class medicines are strictly prohibited and defined as illegal substances, regardless of their only proven effect for ASD patient care. Contributed by the sociostructural elements and necessities, black market amphetamine and ketamine have not only emerged in the regime for decades, but also have become a lucrative business. Their recreational uses are also sometimes accompanied by real necessities and needs; black markets cater to the needs but guidance on the usages is based on word-of-mouth stories without professional medical assistances. There is one case the Principal Investigator (PI) collected, that one person, possibly under depression contributed by PTSD, took relatively high dosage of amphetamine and went into a state of psychosis with overwhelming persecution mania. The study protocol, Psychiatric Orders in Psychoanalytic Treatment of ASD, is therefore designed for an evidence-based approach in treating complex psychiatric disorders with psychoanalytic guidance.

Official Title
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Psychiatric Orders in Psychoanalytic Treatment of ASD

Conditions
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PTSD, Autism Spectrum Disorder High-Functioning, OCD, Agoraphobia With Panic Attacks, Depression, Unipolar, Depression, Anxiety, Depression and Suicide, Depression, Reactive, Depression; Psychoneurotic, Depression Anxiety Disorder, Panic Disorder With Agoraphobia, Severe Agoraphobic Avoidance and Mild Panic Attacks, Anxiety Disorders, ADHD - Combined Type, Borderline Personality Disorder, Social Anxiety Disorder, Avoidant Personality Disorder, Stockholm Syndrome, Grief, Separation Insecurity

Intervention / Treatment
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* Diagnostic Test: Psychoanalysis
* Drug: sertraline 50mg
* Drug: Duloxetine 20 MG
* Behavioral: Cognitive Behavioral Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Persons with ASD. Exclusion Criteria: Severe ASD cases with central nerve system complications.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Participant Case<br>The participant started taking SNRI duloxetine 20 mg/night in Jan. 2023, and changed to SSRI sertraline 50 mg/d in Mar. 2023. The apparent positive psychedelic effects did not take effect until increased dosage to sertraline 100mg/d after around one week in Jun. 2023. Duloxetine is planned to be added to the mix thereon. | Diagnostic Test: Psychoanalysis<br>* Case-specific psychoanalysis is performed, including the participant's background during birth.<br>* Other names: Psychodynamic analysis;Drug: sertraline 50mg<br>* After the initial assessment of 50 mg/d, the treatment dosage is determined at 100 mg/d.<br>* Other names: SSRI;Drug: Duloxetine 20 MG<br>* Duloxetine is used with 20 mg/night for subsidiary effects with sertraline.<br>* Other names: SNRI;Behavioral: Cognitive Behavioral Therapy<br>* CBT is tailored to the participant's current activities and life decisions.<br>* Other names: CBT;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hamilton Anxiety Rating Scale (HAM-A) |  | 90 days | 
| Generalized Anxiety Disorder (GAD-7) |  | 90 days | 
| Dissociative Experiences Scale - II (DES-II) |  | 90 days | 
| The Defeat Scale (D Scale) |  | 90 days | 
| Yale-Brown Obsessive Compulsive Scale (Y-BOCS) |  | 90 days | 
| Severity Measure for Agoraphobia-Adult |  | 90 days | 
| BPD Check List |  | 90 days | 
| Rosenberg Self-Esteem Scale (RSE) |  | 90 days | 
| Young Schema Questionnaire (YSQ) |  | 90 days | 
| Personality Belief Questionnaire (PBQ) |  | 90 days | 
| Behavioral Satisfaction Questionnaire (X axis) | The X axis score total range -150 to +140, from self-centrism (passive-aggressiveness) to proactive social behaviors. | 90 days | 
| Behavioral Satisfaction Questionnaire (Y axis) | The Y axis score total range -200 to +195, from inhibition to excitation of the hypothalamic-pituitary-adrenal (HPA) axis in daily lives. | 90 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart Rate | Heart rate is used to correlate to the participant's mode change. | 90 days | 
| Systolic Blood Pressure | Systolic blood pressure is measured for reference on psychoneurotic correlations. | 90 days | 
| Diastolic Blood Pressure | Diastolic blood pressure is measured for reference on possible side-effects with dizziness etc. | 90 days |