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Pharmacotherapy for mood and anxiety disorders in older people with intellectual disability in comparison with the general population

Axmon, Anna LU ; El Mrayyan, Nadia LU ; Eberhard, Jonas LU and Ahlström, Gerd LU (2019) In BMC Psychiatry 19(1).
Abstract

BACKGROUND: People with intellectual disability (ID) have high prevalence of psychiatric disorders, but even higher rates of prescription of psychotropic drugs. METHODS: Using Swedish national registers, we identified a group of older people with ID and diagnosis of mood disorders (ICD-10 codes F32-F39) and/or anxiety (ICD-10 code F4) during 2006-2012 (n = 587) and a referent group of people from the general population with the same diagnoses during the same time period (n = 434). For both groups, we collected information on prescription of anxiolytics, hypnotics and sedatives, antidepressants, and GABA-agonists. RESULTS: Among those with a diagnosis of anxiety, people with ID were more likely than those in the general population to be... (More)

BACKGROUND: People with intellectual disability (ID) have high prevalence of psychiatric disorders, but even higher rates of prescription of psychotropic drugs. METHODS: Using Swedish national registers, we identified a group of older people with ID and diagnosis of mood disorders (ICD-10 codes F32-F39) and/or anxiety (ICD-10 code F4) during 2006-2012 (n = 587) and a referent group of people from the general population with the same diagnoses during the same time period (n = 434). For both groups, we collected information on prescription of anxiolytics, hypnotics and sedatives, antidepressants, and GABA-agonists. RESULTS: Among those with a diagnosis of anxiety, people with ID were more likely than those in the general population to be prescribed anxiolytics (Relative Risk 1.32 [95% Confidence Interval 1.19-1.46]) and GABA-agonists (1.10 [1.08-1.31]). Moreover, among those with anxiety but without mood disorders, ID was associated with increased prescription of antidepressants (1.20 [1.03-1.39]). Within the ID cohort, behaviour impairment and MSP (i.e. moderate, severe, or profound) ID was associated with increased prescription of anxiolytics, both among those with anxiety (1.15 [1.03-1.30] for behaviour impairment and 1.23 [1.10-1.38] for MSP ID) and among those with mood disorders (1.14 [0.97-1.35] for behaviour impairment and 1.26 [1.04-1.52] for MSP ID). Moreover, MSP ID was associated with increased prescription of GABA-agonists among those with anxiety (1.23 [1.10-1.38]). CONCLUSIONS: The excess prescription of anxiolytics but not antidepressants may suggest shortages in the psychiatric health care of older people with intellectual disability and mood and anxiety disorders.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aging, Down syndrome, Drug prescription, Mental retardation, Sedatives
in
BMC Psychiatry
volume
19
issue
1
article number
238
publisher
BioMed Central (BMC)
external identifiers
  • pmid:31370823
  • scopus:85071001081
ISSN
1471-244X
DOI
10.1186/s12888-019-2191-7
project
Ageing persons with intellectual disability, health and mortality, healthcare utilization and social welfare: a Swedish national longitudinal population study
language
English
LU publication?
yes
id
e03c8347-68e4-4869-ae1d-a592b9b1a6d7
date added to LUP
2019-09-09 11:37:54
date last changed
2020-10-27 02:11:25
@article{e03c8347-68e4-4869-ae1d-a592b9b1a6d7,
  abstract     = {<p>BACKGROUND: People with intellectual disability (ID) have high prevalence of psychiatric disorders, but even higher rates of prescription of psychotropic drugs. METHODS: Using Swedish national registers, we identified a group of older people with ID and diagnosis of mood disorders (ICD-10 codes F32-F39) and/or anxiety (ICD-10 code F4) during 2006-2012 (n = 587) and a referent group of people from the general population with the same diagnoses during the same time period (n = 434). For both groups, we collected information on prescription of anxiolytics, hypnotics and sedatives, antidepressants, and GABA-agonists. RESULTS: Among those with a diagnosis of anxiety, people with ID were more likely than those in the general population to be prescribed anxiolytics (Relative Risk 1.32 [95% Confidence Interval 1.19-1.46]) and GABA-agonists (1.10 [1.08-1.31]). Moreover, among those with anxiety but without mood disorders, ID was associated with increased prescription of antidepressants (1.20 [1.03-1.39]). Within the ID cohort, behaviour impairment and MSP (i.e. moderate, severe, or profound) ID was associated with increased prescription of anxiolytics, both among those with anxiety (1.15 [1.03-1.30] for behaviour impairment and 1.23 [1.10-1.38] for MSP ID) and among those with mood disorders (1.14 [0.97-1.35] for behaviour impairment and 1.26 [1.04-1.52] for MSP ID). Moreover, MSP ID was associated with increased prescription of GABA-agonists among those with anxiety (1.23 [1.10-1.38]). CONCLUSIONS: The excess prescription of anxiolytics but not antidepressants may suggest shortages in the psychiatric health care of older people with intellectual disability and mood and anxiety disorders.</p>},
  author       = {Axmon, Anna and El Mrayyan, Nadia and Eberhard, Jonas and Ahlström, Gerd},
  issn         = {1471-244X},
  language     = {eng},
  month        = {08},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Psychiatry},
  title        = {Pharmacotherapy for mood and anxiety disorders in older people with intellectual disability in comparison with the general population},
  url          = {http://dx.doi.org/10.1186/s12888-019-2191-7},
  doi          = {10.1186/s12888-019-2191-7},
  volume       = {19},
  year         = {2019},
}