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Demographic and diagnostic profiles of older people with intellectual disability and prescription of antipsychotics

Axmon, Anna LU ; Ahlström, Gerd LU ; Gagnemo Persson, Rebecca LU and Eberhard, Jonas LU (2019) In Social Psychiatry and Psychiatric Epidemiology
Abstract
Purpose
To describe demographic and diagnostic profiles in a national cohort of older people with intellectual disability (ID) who were prescribed antipsychotics.
Methods
Using national registers, we identified people with ID who were 55 + years in 2012 (n = 7936), as well as a subcohort with complete information on demographic factors (sex, year of birth, severity of ID, presence of behavior impairment, and residence in special housing; n = 1151). Data regarding diagnoses and prescription of antipsychotics were added for the time period 2006–2012. The potential effects of demographic factors and diagnoses on the prescription of sedating and less-sedating antipsychotics, respectively, were assessed in separate models by... (More)
Purpose
To describe demographic and diagnostic profiles in a national cohort of older people with intellectual disability (ID) who were prescribed antipsychotics.
Methods
Using national registers, we identified people with ID who were 55 + years in 2012 (n = 7936), as well as a subcohort with complete information on demographic factors (sex, year of birth, severity of ID, presence of behavior impairment, and residence in special housing; n = 1151). Data regarding diagnoses and prescription of antipsychotics were added for the time period 2006–2012. The potential effects of demographic factors and diagnoses on the prescription of sedating and less-sedating antipsychotics, respectively, were assessed in separate models by estimating the relative risks (RRs) of prescription.
Results
Of the demographic factors, severe/profound ID (RR 1.17), behavior impairment (RR 1.34), and living in special housing (RR 1.25) were associated with prescription of sedating antipsychotics, whereas only behavior impairment (RR 1.42) was associated with prescription of less-sedating antipsychotics. For both sedating and less-sedating antipsychotics, the diagnoses with the largest association (i.e., highest relative risk) were schizophrenia (RR 2.17 for sedating and RR 1.81 for less-sedating) and ID (RR 1.84 and RR 1.68, respectively), followed by disorders of psychological development (for sedating antipsychotics, RR 1.57) and organic mental disorders (for less-sedating antipsychotics, RR 1.55).
Conclusions
The associations between prescription of antipsychotics and demographic factors and non-psychotic diagnoses, respectively, suggest that older people with ID may be prescribed antipsychotic medication without thorough psychiatric diagnosing. If so, there is a need for improving the abilities of health care professionals to properly diagnose and manage psychiatric illness in this population. (Less)
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author
organization
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type
Contribution to journal
publication status
epub
subject
in
Social Psychiatry and Psychiatric Epidemiology
publisher
Steinkopff
external identifiers
  • scopus:85064161174
ISSN
0933-7954
language
English
LU publication?
yes
id
5455ed6d-ad37-4029-9cd0-9ef9183f8abe
alternative location
http://doi.org/10.1007/s00127-019-01695-w
date added to LUP
2019-03-26 11:12:15
date last changed
2019-05-14 04:52:44
@article{5455ed6d-ad37-4029-9cd0-9ef9183f8abe,
  abstract     = {Purpose<br/>To describe demographic and diagnostic profiles in a national cohort of older people with intellectual disability (ID) who were prescribed antipsychotics.<br/>Methods<br/>Using national registers, we identified people with ID who were 55 + years in 2012 (n = 7936), as well as a subcohort with complete information on demographic factors (sex, year of birth, severity of ID, presence of behavior impairment, and residence in special housing; n = 1151). Data regarding diagnoses and prescription of antipsychotics were added for the time period 2006–2012. The potential effects of demographic factors and diagnoses on the prescription of sedating and less-sedating antipsychotics, respectively, were assessed in separate models by estimating the relative risks (RRs) of prescription.<br/>Results<br/>Of the demographic factors, severe/profound ID (RR 1.17), behavior impairment (RR 1.34), and living in special housing (RR 1.25) were associated with prescription of sedating antipsychotics, whereas only behavior impairment (RR 1.42) was associated with prescription of less-sedating antipsychotics. For both sedating and less-sedating antipsychotics, the diagnoses with the largest association (i.e., highest relative risk) were schizophrenia (RR 2.17 for sedating and RR 1.81 for less-sedating) and ID (RR 1.84 and RR 1.68, respectively), followed by disorders of psychological development (for sedating antipsychotics, RR 1.57) and organic mental disorders (for less-sedating antipsychotics, RR 1.55).<br/>Conclusions<br/>The associations between prescription of antipsychotics and demographic factors and non-psychotic diagnoses, respectively, suggest that older people with ID may be prescribed antipsychotic medication without thorough psychiatric diagnosing. If so, there is a need for improving the abilities of health care professionals to properly diagnose and manage psychiatric illness in this population.},
  author       = {Axmon, Anna and Ahlström, Gerd and Gagnemo Persson, Rebecca and Eberhard, Jonas},
  issn         = {0933-7954},
  language     = {eng},
  month        = {03},
  publisher    = {Steinkopff},
  series       = {Social Psychiatry and Psychiatric Epidemiology},
  title        = {Demographic and diagnostic profiles of older people with intellectual disability and prescription of antipsychotics},
  year         = {2019},
}