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Social Psychiatry and Psychiatric Epidemiology

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Open Access 01-08-2019 | Schizophrenia | Original Paper

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

Authors: Anna Axmon, Gerd Ahlström, Rebecca Gagnemo Persson, Jonas Eberhard

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 8/2019

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 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.

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Title: Demographic and diagnostic profiles of older people with intellectual disability and prescription of antipsychotics
Authors: Anna Axmon
Gerd Ahlström
Rebecca Gagnemo Persson
Jonas Eberhard
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keywords: Schizophrenia
Intellectual Disability
Intellectual Disability
Antipsychotics
Antipsychotics
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 8/2019
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-019-01695-w

At a glance: The STEP trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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